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.
Antimicrobial class: Aminoglycoside
Pregnancy category: D
Average serum half life: 2-3 hours
Biliary penetration: Moderate
CSF penetration: Poor