Final answer:
Oral administration of aminoglycosides is considered appropriate in two situations: to decontaminate the bowel before surgery and as adjunct therapy for hepatic encephalopathy. Their use must be monitored closely due to potential nephrotoxicity, neurotoxicity, and ototoxicity.
Step-by-step explanation:
Administration of Aminoglycosides
Aminoglycosides, such as gentamicin, neomycin, and streptomycin, are powerful antibacterial drugs that operate by binding to the 30S ribosomal subunit in bacteria, which causes faulty proteins to be produced. These proteins disrupt the cytoplasmic membrane leading to bacterial death. Aminoglycosides are commonly administered parenterally due to their high polarity and poor absorption when taken orally. However, there are two exceptions where oral administration of aminoglycosides is considered appropriate:
- Preoperative bowel surgery - Aminoglycosides can be given orally to decontaminate the bowel by killing gut flora, preventing postoperative infections.
- Hepatic encephalopathy - By reducing ammonia-forming bacteria in the gut, which can consequently lower blood ammonia levels, aminoglycosides are given orally as an adjunct therapy.
Due to their potential side effects, including nephrotoxicity, neurotoxicity, and ototoxicity, use of aminoglycosides must be closely monitored, especially in patients with a history of kidney or liver dysfunction.