Monograph Details

Infections & Infestations > Bacterial infections
Amikacin Inj
Manufacturer
Various generic manufacturers
Legal Classification
Rx
Pharmacological Class
Aminoglycoside.
Generic Name
Amikacin sulfate 100mg/2mL, 500mg/2mL, 1g/4mL; soln for IM inj or IV infusion after dilution; contains sulfites.
Indications
Short-term treatment of serious susceptible infections, including septicemia, respiratory tract, bones and joints, CNS (eg, meningitis), skin and skin structure, intra-abdominal (eg, peritonitis), burns and postoperative infections, complicated and recurrent UTIs or uncomplicated UTIs not susceptible to other antibiotics.
Children
Infants: give by IM inj; or IV infusion over 1–2 hours. Newborns: loading dose: 10mg/kg; then follow with 7.5mg/kg every 12 hours. All other children and older infants: give by IM inj; or IV infusion over 30–60 mins. 15mg/kg per day in 2–3 divided doses (7.5mg/kg every 12 hours or 5mg/kg every 8 hours); max 15mg/kg/day. Usual duration: 7–10 days. Renal impairment: adjust dose based on serum levels or reduce frequency; see literature.
Adults
Give by IM inj; or IV infusion over 30–60 mins. 15mg/kg per day in 2–3 divided doses (7.5mg/kg every 12 hours or 5mg/kg every 8 hours); max 15mg/kg/day. Heavier wt. patients: max 1.5g/day. Usual duration: 7–10 days. Uncomplicated UTIs: 250mg twice daily. Renal impairment: adjust dose based on serum levels or reduce frequency; see literature.
Precautions
Monitor for nephro- and neurotoxicity; avoid peak serum levels >35micrograms/mL and trough levels >10micrograms/mL. Discontinue or adjust dose if auditory, vestibular, or renal dysfunction develops; monitor serum levels periodically. Monitor BUN, CrCl, serum creatinine levels before, frequently during, and after therapy. Perform audiogram in high-risk patients. Maintain adequate hydration. Prolonged use or excessive doses. Asthma. Muscular disorders (eg, myasthenia gravis, parkinsonism, or infant botulism). Elderly. Premature or neonatal infants. Pregnancy (Cat.D); avoid use. Nursing mothers: not recommended.
Interactions
Avoid concomitant furosemide, ethacrynic acid. Diuretics may increase toxicity. Increased risk of neurotoxicity and/or nephrotoxicity with concurrent or sequential polymyxin B, colistin, amphotericin B, other nephrotoxic or neurotoxic drugs; avoid. May potentiate neuromuscular blockade, respiratory paralysis with anesthetics, neuromuscular blockers. May be antagonized by concomitant penicillins, cephalosporins.
Adverse Reactions
Nephrotoxicity (eg, azotemia, oliguria), ototoxicity, neurotoxicity, neuromuscular blockade (eg, muscular paralysis, apnea); rare: rash, drug fever, headache, tremor, GI upset, paresthesia, eosinophilia, arthralgia, anemia, hypotension, hypomagnesium.
How Supplied
Contact supplier.
Additional Resources
Related Prescribing Note