Amikacin
General
- Type: Aminoglycoside
- Dosage Forms: injectable solution
- Routes of Administration: IM, IV
- Common Trade Names: Amikin
Adult Dosing
- Bacterial infections
- 7.5mg/kg IM/IV q12h OR
- 5mg/kg IM/IV q8h
- Uncomplicated UTI
- 250mg IM BID
Pediatric Dosing
- Neonates:
- 10mg/kg IM/IV x 1 THEN
- 7.5mg/kg IM/IV q12h
- Infants / Children
- 5mg/kg IM/IV q8h MAX 1.5 g/day
Special Populations
- Pregnancy Rating: D
- Lactation: Safety Unknown
- Renal Dosing
- Adult
- CrCl 50-80 give q12-24h
- CrCl 10-50 give q24-48h
- CrCl <10 give q48-72h
- HD: give supplement
- Pediatric
- CrCl 30-50 give q12-18h
- CrCl 10-29 give q18-24h
- CrCl <10 give q48-72h
- HD/PD start 5mg/kg x 1, no supplement
- Adult
- Hepatic Dosing Not Defined
Contraindications
- Allergy to class/drug
Caution if:
- hypersensitive to sulfites
- renal impairment
- dehydration
- concurrent nephrotoxic agent use
- impaired auditory/vestibular function
- concurrent ototoxic/neurotoxic agent use
- neuromuscular disease
- electrolyte abnormalities
Adverse Reactions
Serious
- Nephrotoxicity
- Ototoxicity
- Neurotoxicity
- Neuromuscular blockade
- Superinfection
Common
- Elev. BUN / Cr
- Hearing loss / tinnitus
- Vertigo
- Injection site reaction
Pharmacology
- Half-life: 2h (30-86 h in renal impairment)
- Metabolism: None
- Excretion: Urine
- Mechanism of Action: Bactericidal, binds to 30S ribosomal subunit, inhibits protein synthesis.
Antibiotic Sensitivities[1]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
References
- ↑ Sanford Guide to Antimicrobial Therapy 2014