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Therapy of gram negative organisms resistant to gentamicin and tobramycin but susceptible to amikacin (HAP, UTI, other).
As combination therapy for the treatment of some Mycobacteria spp (i.e. M. abscessus).
Laboratory
Clinical
Increased nephrotoxicity with: amphotericin B, cyclosporine, cisplatin, NSAIDS, contrast dye, vancomycin.
Increased ototoxicity when given concomitantly with loop diuretics.
Penicillins: in vitro inactivation. Do not mix or run in the same tubing.
Neuromuscular blockade agents: respiratory paralysis.
Antimicrobial class: Aminoglycoside
Pregnancy category: D - risk of eighth cranial nerve toxicity in fetus is well documented with other aminoglycosides and could potentially occur with amikacin
Breastfeeding: Compatible with breastfeeding. Only a trace amount of amikacin was found in some nursing infants. Due to the poor absorption of aminoglycoside, the systemic toxicity should not occur, but an alteration in normal bowel flora may occur in nursing infants.
Average serum half life: 2.5 hours
Distribution: Hydrophilic; 0.2-0.4 L/kg (may be higher in pregnancy, ascites, edema, sepsis, and burn pts); distributed in extracellular fluid, abscesses, ascites fluid, pericardial fluid, pleural fluid, synovial fluid, lymphatic fluid and peritoneal fluid. Poor distribution into bile, aqueous humor, bronchial secretions, abscess, sputum, and CSF.
Biliary penetration: Moderate
CSF penetration: Poor
Urine penetration: Therapeutic
Adapted from the UCLA Health Antimicrobial Stewardship Program