Antimicrobials
Amikacin

Amikacin

Restricted

Low
N/A

Spectrum of Activity

Dosing

General Information

HEALTH CANADA APPROVED

  • Therapy of gram negative organisms that are resistant to gentamicin and tobramycin but susceptible to amikacin
  • As combination therapy for the treatment of some Mycobacteria species
  • Elderly: half life prolonged. Longer intervals between doses may be more important than reduced doses. Monitor renal function and drug levels carefully
  • Risk of aminoglycoside-related toxicity appears to increase after 5 to 7 days
  • Hepatic impairment – may be more prone to nephro- or ototoxicity
  • Neuromuscular disease (including parkinsonism), or hypocalcemia - possible increased neuromuscular blockade
  • Pregnancy/Breast Feeding: Contact pharmacy for most recent information
  • Loop diuretics (eg furosemide) - additive ototoxicity
  • Nephrotoxic drugs (eg amphotericin B, cycloSPORINE and NSAID) - increased risk of nephrotoxicity
  • Neuromuscular blocking agents and general anesthetics - possible prolonged action and/or respiratory paralysis
  • Extended spectrum penicillins (eg ticarcillin, piperacillin) may chemically inactivate amikacin and reduce serum levels. Usually only clinically significant in patients with severe renal impairment

RENAL

  • Nephrotoxicity – dose related; more frequent during prolonged therapy. Usually reversible

NEUROLOGIC

  • Ototoxicity: Eighth cranial nerve damage (auditory and vestibular) associated with excessive doses in renal failure. May be irreversible
  • Neuromuscular blockade (rare): Calcium may help to reverse

Can be given IM

Subcutaneous use: not recommended (kinetic issues, necrosis at injection site)

Antimicrobial class: Aminoglycosides

Pregnancy category: D

Average serum half life: 2.5 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Poor

Biliary penetration: Moderate

pH: 3.5 to 5.5