[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Aminoglycosides](https://durgical.com/en/pharmacology/classes/aminoglycosides/) › Plazomicin

[Pharmacology](https://durgical.com/en/pharmacology/) · [Aminoglycosides](https://durgical.com/en/pharmacology/classes/aminoglycosides/)

# Plazomicin

A newer aminoglycoside built to resist modifying enzymes; used for complicated urinary infections, including carbapenem-resistant ones.

Updated 2026-11-01

- Class: [Aminoglycosides](https://durgical.com/en/pharmacology/classes/aminoglycosides/)
- Target: Decoding (A) site of the bacterial 16S rRNA, 30S ribosomal subunit
- ATC code: J01GB14
- WHO Model List of Essential Medicines

## 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 →](https://durgical.com/en/conditions/acute-pyelonephritis/)

## Adverse effects

### Common

- Diarrhoea, nausea
- Rising creatinine

### Serious (rare, important)

- Kidney injury
- Hearing loss, sometimes permanent; dizziness and vertigo
- Neuromuscular blockade: weakness, worse in myasthenia gravis
- Fetal harm

## 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.

## Memory aid

PLAZOMICIN = «Plan Z» aminoglycoside: the enzymes cannot disarm it, but the kidney and ear risks stay.

## 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.

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## Related drugs

- [Amikacin](https://durgical.com/en/pharmacology/amikacin/)
- [Gentamicin](https://durgical.com/en/pharmacology/gentamicin/)
- [Meropenem](https://durgical.com/en/pharmacology/meropenem/)

## Related conditions

- [Acute pyelonephritis](https://durgical.com/en/conditions/acute-pyelonephritis/)

[← Back to the class: Aminoglycosides](https://durgical.com/en/pharmacology/classes/aminoglycosides/)

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](https://medlineplus.gov/druginfo/meds/a618037.html) (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.

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Source: https://durgical.com/en/pharmacology/plazomicin/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/plazomicin/