Kanamycin

Dosing

Usual dose

Age <50y 15 mg/kg (max 1 g) IM/IV q24h

Age ≥50y 10 mg/kg (max 750 mg) IM/IV q24h

Usual dose 15 mg/kg IM/IV q24h (max 1 g)

No dose adjustment

CrCl 90CrCl 70CrCl 50CrCl 30CrCl 20CrCl 10CrCl 0HD15 mg/kg IV q24h12 mg/kg IV q24h7.5 mg/kg IV q24h4 mg/kg IV q24h7.5 mg/kg IV q48h4 mg/kg IV q48h3 mg/kg IV q48h3 mg/kg IV q48h after HD

General Information

Black Box Warning: Patients treated with aminoglycosides by any route should be under close clinical observation because of the potential toxicity associated with their use. As with other aminoglycosides, the major toxic effects of kanamycin are its action on the auditory and vestibular branches of the eighth nerve and the renal tubules.

Measure peak (30-90 minutes after injection) and trough (just prior to the next dose) kanamycin serum concentrations intermittently during therapy.

Obtain acid-fast bacilli (AFB) smear and culture from sputum at least monthly until 2 consecutive culture specimens are negative.

Perform chest x-rays after 2 to 3 months of treatment in patients with negative initial cultures and at end of treatment.

Obtain serial audiograms and monitor vestibular function.

Monitor renal function; urine.

  • Nausea

  • Vomiting

  • Diarrhea

  • Headache

  • Nervousness

  • Restlessness

  • Paresthesias

  • Blurred vision

  • Neuromuscular paralysis, respiratory paralysis

  • Myasthenia gravis

  • Deafness

  • Ototoxicity

  • Nephrotoxicity

  • Aminoglycosides

  • Nondepolarizing neuromuscular blocking agents

  • Diuretic agents (e.g. Ethacrynic acid)

  • Ascorbic acid

  • Cidofovir

  • Colistimethate sodium

  • Foscarnet

  • Furosemide

  • Lysine

  • Cholera vaccine, live

Antimicrobial class: Aminoglycoside

Pregnancy category: D

Average serum half life: 2-3 hours

Biliary penetration: Moderate

CSF penetration: Poor

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