AMIKACIN

Broad-spectrum aminoglycoside antibacterial with activity against Pseudomonas aeruginosa and some Gram-positive organisms.

Dosage Forms

Powder for injection

1000 mg

Uses

  • Serious Gram-negative infections resistant to gentamicin
  • Multi-drug resistant tuberculosis (MDR-TB)

Dose and Duration

All indications (serious Gram-negative infections resistant to gentamicin)
Adult and child over 12 years: by IM or by slow IV injection or by infusion over 30–60 minutes, 15 mg/kg daily in a single or 2 divided doses (max 1.5 g/ day) for 7–10 days
Child 4 weeks–12 year: by IM or slow IV, 15–20 mg/kg/day as a single dose or divided into 2 equal doses for 7–10 days
Neonate: Give a loading dose of 10 mg/kg followed by 7.5 mg/kg every 12 hours for 7–10 days
Premature infant: by IM or IV injection or IV infusion over 1–2 hours, 7.5 mg every 12 hours for 7–10 days
Multi-drug resistant tuberculosis
Adult and child: 15−20 mg/kg daily. Max 750 mg in children and 1000 mg in adults
Note: For multiple daily dose regimen, one-hour serum concentration should not exceed 30 mg/litre; pre-dose concentration should be less than 10 mg/litre. For once daily dose regimen, pre-dose concentration should be less than 5 mg/litre

Contraindications

  • History of hypersensitivity or serious toxic reactions to aminoglycosides
  • Hypersensitivity to amikacin
  • Myasthenia gravis

Side Effects

  • Anaphylaxis
  • Ototoxicity
  • Nephrotoxicity

Interactions

  • Alcuronium (enhanced effects of alcuronium)
  • Ciclosporin (increased risk of nephrotoxicity)
  • Cisplatin (increased risk of nephrotoxicity)
  • Furosemide (increased risk of ototoxicity)
  • Neostigmine (antagonism of neostigmine effects)
  • Pyridostigmine (antagonism of pyridostigmine effects)
  • Suxamethonium (antagonism of suxamethonium effects)
  • Vecuronium (enhanced effects of vecuronium)

Pregnancy

  • Do not use

Breastfeeding

  • Can be used (see caution)

⚠️ Caution

  • Ensure adequate hydration of the patient during therapy
  • Use with caution in pre-existing renal insufficiency, hear ing or vestibular damage or diminished glomerular filtration.
    Monitor renal, vestibular and auditory function
  • Parenteral treatment should not exceed 7 days if possible to minimize side effects.
  • Increase dose interval in renal impairment. Reduce dose in severe renal impairment
  • For MDR-TB, amikacin can be used in pregnancy and breastfeeding as benefits outweigh risks