Miscellaneous antibacterial drugs

This review of the 2010 publications on miscellaneous antibiotics covers aminoglycosides (amikacin, gentamicin, and paromomycin), fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin, ofloxacin, and prulifloxacin), glycopeptides (teicoplanin, telavancin, and vancomycin), the ketolide telithromycin, the lincosamide clindamycin, macrolides (azithromycin, clarithromycin, erythromycin, and spiramycin), nitrofurantoin, the oxazolidinone linezolid, the polymyxin colistin, streptogramins (pristinamycin, and quinupristin + dalfopristin), sulfonamides, trimethoprim, and co-trimoxazole, daptomycin, fosfomycin, and fusidic acid. Important and new information reviewed in more detail includes genetic susceptibility factors for aminoglycoside ototoxicity and immunological cross-reactions between quinolones. Several newer drugs have enhanced activity against resistant Gram-positive bacteria and adverse events are reviewed. Adverse events frequently associated with linezolid include anemia, thrombocytopenia, peripheral neuropathy, and gastrointestinal reactions. A large number of subjects have been enrolled in Daptomycin Registry studies; 2–4% had raised creatine kinase activity and gastrointestinal reactions were generally more common than with comparator drugs; creatine kinase activity should be monitored during use of daptomycin. Use of pristinamycin was associated with gastrointestinal reactions, rash, and neutropenia. An update on colistin toxicity, especially nephrotoxicity, is also included.