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Haematology/Oncology & HPCT patients with fever and neutropenia
EAP (Injection)
Nephrotoxicity (non-oliguric) - less common with once daily dosing; greater toxicity with longer duration and supratherapeutic trough levels; avoid concomitant nephrotoxins
Vestibulocochlear toxicity (irreversible) - audiology testing is recommended if prolonged or recurrent use, such as in Cystic Fibrosis
Can exacerbate neuromuscular blockade - e.g. contraindicated in patients with myasthenia gravis
Enhanced nephrotoxic effect with concomitant use of other nephrotoxins
Enhanced ototoxicity with loop diuretics (e.g. furosemide)
Non-depolarizing muscle relaxants may be potentiated
Calculate amikacin dose based on actual body weight unless patient weighs ≥125% of ideal body weight in which case dose is based on adjusted body weight
Dosage Guidelines for Haematology/Oncology and HPCT patients apply to children with normal renal function
8A, 8B patients awaiting transplant should receive q24h aminoglycoside therapy when indicated for fever/infection
Antimicrobials
