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Tobramycin is highly active with respect to Gram-negative microorganisms (blue-pus bacillus and gastric bacilli, rabbit fever, serratia, providencia, enterobacteria, proteus, salmonella, shigella), as well as Gram-positive microorganisms (staphylococci, including those resistant to penicillin and some cephalosporins), and a few strains of streptococci.

It is used for severe bacterial infections: peritonitis, sepsis, meningitis, osteomyelitis, endocarditis, pneumonia, pleural empyema, pulmonary abscess, purulent skin infections and soft tissue infections, and infections of the urinary tract caused by microorganisms that are sensitive to the drug. Synonyms of this drug are nebicine, obracine, and others.

Gentamicin: Gentamicin is a complex of antibiotics isolated from a culture liquid of the actinomycete M. purpurea, which consists of a mixture of approximately equal amounts of three compounds: gentamicines C1, C1a, and C2 [271-278].

Gentamicin Q (R = R1 = CH3) Gentamicin C2 (R = CH3, R1 = H) Gentamicin C1A (R = R1 = H)

Gentamicin has a broad spectrum of biological action, and is highly active with respect to strains of staphylococci that are resistant to penicillins and other antibiotics, many Gramnegative microorganisms: blue-pus bacillus, rabbit fever, enterobacter, salmonella, shigella, and proteus.

It is used for pyelonephritis, cystitis, pneumonia, pleural empyema, peritonitis, sepsis, meningitis, purulent skin and soft tissue infections, infected wounds, burns, and so on, which are caused by microorganisms that are sensitive to the drug. Gentamicin is the drug of choice for severe bacterial infections caused by undetermined stimuli. Synonyms of this drug are garamycin, gentacylin, ribomycin, and many others.

Amikacin: Amikacin, 0-3-amino-3-deoxy-a-D-glucopyranosyl-(1^4)-ü-[6-amino-6-deoxy-a-D-glucopyranosyl-(1^6)]-N3-(4-amino-L-2-hydroxybutyryl)-2-deoxy-L-strepta-mine (3.4.10), is a semisynthetic antibiotic that is synthesized from kanamycin (3.4.6). The primary amino group in this molecule is previously protected by acylating it with N-(benzoyloxycarbonyloxy) succinimide in dimethylformamide, after which the resulting product (32.4.9) is treated with an ester synthesized from N-hydroxysuccinimide and ben-zyloxycarbonylamino-a-l-(-) hydroxybutyric acid, and as a result the 4-amino group of the streptamine region of the molecule is selectively acylated. Further removal of two ben-zyloxycarbonylamine protective groups in the traditional manner, via hydrogen reduction using a palladium on carbon catalyst, forms the desired amikacin (32.4.10) [279-286].

Amikacin is highly effective with respect to Gram-negative microorganisms (blue-pus and gastric bacilli, rabbit fever, serratia, providencia, enterobacteria, proteus, salmonella, shigella), as well as Gram-positive microorganisms (staphylococci, including those that are resistant to penicillin and some cephalosporins), and a few strains of streptococci.

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