Kanamycin

Administration

  • Type: Aminoglycoside
  • Dosage Forms: 1 g/3 mL
  • Routes of Administration: IM, IV

Adult Dosing

  • Bacterial Infections: 7.5mg/kg IM/IV q12h
    • For obese patients, use adjusted wt of IBW + 0.4 x (ABW - IBW)
    • Adjust dose based on serum levels

Pediatric Dosing

  • Bacterial Infections: 7.5mg/kg IM/IV q12h

Special Populations

  • Pregnancy Risk Factor: D

Renal Dosing

  • CrCl 50-80: give q12-24h
  • CrCl 10-50: give q24-72h
  • CrCl <10: give q48-72h

Contraindications

  • Allergy to class/drug
  • Caution if:
    • sulfite hypersensitivity
    • renal impairment, dehydration, concurrent nephrotoxic agent use
    • impaired auditory or vestibular function, concurrent ototoxic or neurotoxic agents
    • neuromuscular disease
    • electrolyte abnormalities
    • prolonged use, high dose treatment
    • neonates/infants or elderly

Adverse Reactions

  • Nephrotoxicity
    • Increased risk with renal impairment, high dose, prolonged treatment
    • Monitor renal function, peak/trough levels
  • Neuromuscular Blockade
    • Risk of respiratory paralysis possible with any route of administration

Black Box Warnings

  • Neurotoxicity/Ototoxicity
    • Increased risk with renal impairment, high dose, prolonged treatment

Serious

  • Nephrotoxicity
  • Ototoxicity (auditory or vestibular)
  • Neurotoxicity, neuromuscular blockade

Common

  • Hearing loss, tinnitus, vertigo
  • BUN, creatinine elevated

Pharmacology

  • Half-life: 2-4 hrs
  • Metabolism: CYP 450
  • Excretion: Urine

Mechanism of Action

  • Interferes with protein synthesis in bacterial cell by binding to ribosomal subunit

References

<UpToDate, MicroMedex/>