BC Women's Hospital logo
Guidelines
Amikacin Neonatal Dosing

Amikacin Neonatal Dosing

Infants with HIE or Renal Impairment

In infants with impaired renal function and those with moderate to severe HIE receiving induced hypothermia give an initial dose as per PNA and PMA above and order two post dose levels

Consult with NICU pharmacist for timing of levels

Administration

In the NICU and IN all doses are to be infused by syringe pump over 30 minutes

Aminoglycoside antibiotics (amikacin, gentamicin, tobramycin) may be inactivated by ampicillin when infused through the same IV line right after ampicillin. For all first doses of ampicillin and amikacin administer the antibiotics one right after another using the following procedure:

  1. Administer ampicillin first
  2. Flush manually at the medication port with 3mL of NS. IF you have a PICC, you must use a pump (attach the NS pre-filled sterile syringe tubing to the medication port and press the "volume over time" feature; set it for 3mL over 5 minutes)
  3. Administer the amikacin
  4. For all subsequent doses, schedule the administration times so that the antibiotics are given 1 hour apart from each other
  5. NOTE: Ampicillin and amikacin can be administered at the same time without flushing or separation of administration times when each drug is infused through a separate PIV line or through different lumens of a double or triple lumen catheter