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Amikacin

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Amikacin, Amikacin Sulfate, Arikayce, Amiglyde-V

  • See Also
  1. Aminoglycoside
  • Indications
  1. Gram Negative Infections
  2. Cystic Fibrosis respiratory exacerbation
  3. Tuberculosis (second-line agent)
  • Mechanism
  1. See Aminoglycoside
  2. Amikacin is derived from Kanamycin
  • Dosing
  1. Gram Negative Infections in Adults and Children (FDA Approved dosing)
    1. Give 15 mg/kg/day (max 1500 mg/day) IM or IV divided every 8 to 12 hours
    2. Once daily 15 mg/kg dose is used off-label
  2. Gram Negative Infections in Newborns (age <1 month)
    1. Give 10 mg/kg IM or IV load, then 7.5 mg/kg IM or IV every 12 hours
  3. Cystic Fibrosis Respiratory Exacerbation
    1. Give 30 to 35 mg/kg IV every 24 hours and adjust dose based on levels
    2. Target peak 80 to 120 mcg/ml
    3. Target trough <10 mcg/ml
  • Adverse Effects
  1. See Aminoglycoside
  2. Aminoglycosides are associated with risk of Ototoxicity and nephrotoxicity (FDA black box warning)
    1. See Aminoglycoside for risk factors
  • Safety
  1. Pregnancy Category D
  2. Considered safe in Lactation
  • Resources
  1. Amikacin Injection Solution (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e2abecaf-9532-45a0-a284-5697b2aa38f1
  • References
  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. Sizar (2023) Amikacin, StatPearls, Treasure Island, FL
    1. https://www.ncbi.nlm.nih.gov/books/NBK430908/