Restricted
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).
Monitor creatinine at least 3 times/week. Discontinue if any signs of ototoxicity.
For BID dosing: Target Peak 15-30 mg/L, Trough <5 mg/L. Peak levels usually not required but if drawn, record time of dose and time of level draw as accurately as possible.
Consult pharmacist for level interpretation and dose individualization.
For once daily dosing: Target Trough <1 mg/L. Peak levels not recommended.
Nephrotoxicity (non-oliguric)
Vestibulocochlear toxicity
Other
Increased nephrotoxicity with:
Increased ototoxicity with:
Respiratory paralysis with:
Formal audiology assessment required if planning to use aminoglycoside for >7d or if symptoms develop is strongly suggested.
Inform patient of risk of ototoxicity and to report any symptoms.
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