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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › AMINOGLYCOSIDE ANTIBACTERIALS › Other aminoglycosides
amikacin
J01GB06
Forms & Strengths
- Injection: 50 mg/mL, 250 mg/mL, 500 mg/2 mL
Adult Dosing
- Severe systemic infections: 15 mg/kg/day divided every 8 to 12 hours IV or IM
- Max daily dose: 15 mg/kg/day (typically not exceeding 1.5 g/day unless monitoring levels)
- Once-daily dosing regimen: 15 to 20 mg/kg IV every 24 hours based on pharmacokinetic monitoring
Pediatric Dosing
- Neonates: Loading dose of 10 mg/kg, then 7.5 mg/kg every 12 hours IV or IM
- Infants and children: 15 to 22.5 mg/kg/day divided every 8 hours IV or IM
Indications
- Severe infections caused by susceptible Gram-negative bacteria (Pseudomonas, Escherichia coli, Klebsiella, Enterobacter, Serratia, Acinetobacter)
- Second-line treatment of drug-resistant tuberculosis (MDR-TB)
Mechanism of Action
- Semi-synthetic aminoglycoside antibiotic that binds irreversibly to the 30S ribosomal subunit of susceptible bacteria
- Inhibits protein synthesis and misreads genetic code, leading to bacterial cell death
Contraindications
- Hypersensitivity to amikacin or other aminoglycosides
- History of severe hypersensitivity or toxic reactions to aminoglycosides
Adverse Reactions
- Nephrotoxicity (elevated serum creatinine, blood urea nitrogen, acute tubular necrosis)
- Ototoxicity (auditory damage, tinnitus, vestibular toxicity, dizziness)
- Neurotoxicity and neuromuscular blockade (muscle weakness, apnea)
- Injection site reactions, pain, and phlebitis
Drug Interactions
- Concurrent or sequential use of other neurotoxic, ototoxic, or nephrotoxic agents (e.g., amphotericin B, vancomycin, cisplatin, polymyxins, loop diuretics)
- Potentiation of neuromuscular blockade when administered with neuromuscular blocking agents or general anesthetics
Curated Content: Needs Vetting Before Put to Clinical Use