Pharmacology · Aminoglycosides
Plazomicin !
A newer aminoglycoside built to resist modifying enzymes; used for complicated urinary infections, including carbapenem-resistant ones.
Updated 2026-11-01
Mechanism of action
Plazomicin, a semisynthetic derivative of sisomicin, binds the 30S ribosomal subunit and causes mRNA misreading like other aminoglycosides. Structural changes make it a poor substrate for most aminoglycoside-modifying enzymes, so it keeps activity against many multidrug-resistant gram-negatives, including carbapenem-resistant isolates.
- Resists most aminoglycoside-modifying enzymes
- Binds the 30S ribosomal subunit
- Misreading kills the bacterium
Pharmacokinetics
- Absorption
- Intravenous infusion once a day.
- Elimination
- Through the kidney; kidney problems are more frequent in older adults.
Indications
- Complicated urinary tract infections, including pyelonephritis, in patients with few other options. Acute pyelonephritis →
Adverse effects
Common
- Diarrhoea, nausea
- Rising creatinine
Contraindications
- Hypersensitivity to aminoglycosides
Key interactions
- Other nephrotoxic or ototoxic drugs
- Added kidney and hearing damage.
What is monitored
- Kidney function before and during treatment
- Hearing tests before and during treatment
Administration and safety
- IV infusion once daily; it may be given at home after teaching.
- Check the drug name: several aminoglycosides have similar names.
Nursing care
- Baseline creatinine and hearing history, including family history of drug-related deafness.
- Ask about myasthenia gravis or Parkinson disease.
- Teaching: report tingling, twitching, weakness, ringing or hearing loss.
Pregnancy and breastfeeding
Like other aminoglycosides, plazomicin can harm the fetus; a pregnancy is reported to the treating team at once.
Test yourself
Think of the answer, then tap the question to see it.
Why does plazomicin work against many aminoglycoside-resistant gram-negatives?
Its structure makes it a poor substrate for most aminoglycoside-modifying enzymes.
Which infections is plazomicin approved for?
Complicated urinary tract infections, including pyelonephritis.
Which tests are done before and during plazomicin treatment?
Kidney function and hearing tests, because of nephrotoxicity and ototoxicity.
Related drugs
Related conditions
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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Plazomicin Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 59 (McGraw Hill, 2023).
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Representative model, for educational purposes only.