Neomycin Reduces the Intestinal Production of Ammonia from Glutamine

Hepatic encephalopathy

“…Benefits from neomycin, the most widely used drug, are attributed to effects on colonic bacteria. However, neomycin will also affect the small bowel mucosa and may impair the activity of glutaminase in intestinal villi (43). Metronidazole, affecting a different bacterial population than neomycin, will also improve encephalopathy (44).…”

The Management of Hospitalized Patients with Cirrhosis: The Mount Sinai Experience and a Guide for Hospitalists

“…It is important to recognize that even minimal systemic absorption of antibiotics used to treat PSE may result in serious adverse effects [101,106,107]. Neomycin is poorly absorbed following oral administration, but cumulative systemic absorption following prolonged use can cause hearing loss and renal failure [101].…”

The Rise of Glutaminase in End-Stage Liver Diseases

“…DON has been used in the inhibition of glutaminase in cell cultures of astrocytes in studies demonstrating the importance of GA activity in cell damage induced by ammonia. Also, in rats subjected to portocaval shunt, neomycin inhibits intestinal glutaminase activity (Hawkins, Jessy et al 1994), although the mechanisms by which neomycin may inhibit glutaminase activity are not described. GA activity is increased in patients with high levels of nitric oxide, glucagon, or tumor necrosis factor, and in a wide number of cancer types as in liver, breast and leukemia as glutamine is implied as a factor in in cell proliferation (Perez-Gomez C 2005; Gao P 2009).…”