Antimicrobials
Amikacin

Amikacin

Low
N/A
$ (<$25/day)

Spectrum of Activity

Dosing

General Information

In general, aminoglycosides are used in combination with a β-lactam antibiotic and are not used as monotherapy in the treatment of infections other than cystitis or pyelonephritis.

  • Renal function

  • Auditory exam with prolonged therapy

  • Therapeutic drug monitoring

  • Nephrotoxicity

  • Ototoxicity

  • Neuromuscular blockade (avoid in patients with myasthenia gravis)

  • Distribution:

    • Vd: 0.25 L/kg
    • Primarily into extracellular fluid (highly hydrophilic); poor penetration into the blood-brain barrier even when meninges are inflamed; Vd is increased in neonates and patients with edema, ascites, fluid overload; Vd is decreased in patients with dehydration
  • CSF:blood level ratio:

    • Normal meninges: <10%; Inflamed meninges: ≤25%
  • Lung:blood level ratio

    • Bronchial secretions Cmax (peak):serum Cmax (peak) ratio: ~30% to 40%
    • Epithelial lining fluid Cmax (peak):Cmax (peak) ratio: ~10% to 18%
  • Protein binding: 0% to 11%

  • Half-life elimination: ~2 hours

  • Excretion: Urine (94% to 98% unchanged)