Administration
Preparation
Dilution
Compatibility
Therapy of gram negative organisms resistant to gentamicin and tobramycin but susceptible to amikacin (HAP, UTI, other).
As combination therapy for the treatment of some Mycobacteria species (e.g. M. abscessus).
IV only: Tier 2 Protected Antimicrobial Broad spectrum, but 1st line for common infections, comes with a high risk of poor stewardship if initial workup and follow-up are not in place
Strategies Used:
Monitor creatinine at least 3 times/week. Discontinue if any signs of ototoxicity.
Hartford Nomogram
Traditional Dosing
Trough level is 0-60min before a dose (usually pre-4th), and peak is 30-60min after dose infused (usually post-3rd).
In critically ill patients, consider checking peak level after the 1st dose as volume of distribution and renal function may change rapidly.
Monitor creatinine at least 3 times/week. Discontinue if any signs of ototoxicity.
Inform patient of risk of ototoxicity and to report any symptoms.
Nephrotoxicity (non-oliguric)
Vestibulocochlear toxicity
Other
Increased nephrotoxicity with:
Increased ototoxicity with:
Respiratory paralysis with:
Antimicrobial class: Aminoglycoside
Pregnancy category: D
Average serum half life: 2.5 hours
Urine penetration: Therapeutic
Lung penetration: Therapeutic
CSF penetration: Poor
Biliary penetration: Moderate