Amikacin is used to treat Gram negative bacilli, including Pseudomonas aeruginosa and used in combination with other antimicrobials for the treatment of some Mycobacteria spp.
All aminoglycosides carry potential for tubular necrosis and renal failure, deafness due to cochlear toxicity, vertigo due to damage to vestibular organs, and rarely, neuromuscular blockade. If considering using amikacin, strongly consider ID consultation and contact Pharmacy to assist with appropriate dosing.
Monitor serum creatinine and urea 2-3 times/week. Discontinue if any signs of vestibulotoxicity or ototoxicity.
All aminoglycosides carry potential for cochlear, renal and vestibulotoxicity. If considering using amikacin, strongly consider ID consultation.
For once daily/extended interval dosing dosing:
A single serum concentration can be drawn between 6 to 14 hours after the start of the aminoglycoside infusion (typically an 8-10 hour post concentration is drawn.) This concentration is then divided by 2 and then plotted on the Hartford dosing nomogram.
For conventional multiple times per day dosing:
For Cystic Fibrosis modified extended interval dosing:
For Intermittent OR Continuous dialysis:
Nephrotoxicity (non-oliguric)
Vestibulocochlear toxicity
Other
Increased risk of nephrotoxicity with concomitant use of:
Increased ototoxicity with:
Respiratory paralysis with:
Antimicrobial class: Aminoglycoside
Pregnancy category: D
Average serum half life: 2.5 hours
Biliary penetration: Moderate
CSF penetration: Poor
Lung penetration: Therapeutic
Urine penetration: Therapeutic
All aminoglycosides carry potential for tubular necrosis and renal failure, deafness due to cochlear toxicity, vertigo due to damage to vestibular organs, and rarely, neuromuscular blockade. If considering using amikacin, strongly consider ID consultation and contact Pharmacy to assist with appropriate dosing.
Perform baseline and ongoing weekly otovestibular toxicity assessment. Formal audiology assessment required if symptoms develop.
Inform patient of risk of ototoxicity and to report any symptoms.
Calculation of Dosing Body Weight (DBW) DBW = IBW + [(ABW - IBW) x 0.4]
where: IBW male = 50kg + 0.906kg [Height (cm) - 152.4cm] IBW female = 45kg + 0.906kg [Height (cm) - 152.4cm]
Dosing Body Weight = DBW Ideal Body Weight = IBW Actual Body Weight = ABW