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Kanamycin

In its naturally occurring form kanamycin is a mixture of three closely related compounds, kanamycin A, B, and C. Pharmaceutical preparations consist almost exclusively of kanamycin A, although kanamycin B (bekanamycin) is available in some countries. The spectrum of activity is similar to that of streptomycin (and includes M. tuberculosis), but it retains activity against streptomycin-resistant strains and is less likely to cause vestibular damage.
Kanamycin has largely been superseded by gentamicin and tobramycin (deoxykanamycin B), which are more active against many enterobacteria and, more importantly, include Ps. aeruginosa in their spectrum. This has been a major factor in the popularity of these agents for the empirical therapy of serious infection before the results of laboratory tests are known. The relative merits of gentamicin and tobramycin have been the subject of much debate.

Other members of the kanamycin group are available in some countries. They include sisomicin, dibekacin, micronomicin (gentamicin C2B), ribostamycin, and astromicin. They offer little advantage over gentamicin or tobramycin, although some have different patterns of stability to aminoglycoside-modifying enzymes.

 

 

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