Reminder Amikacin levels cannot be processed in house and must be sent out. Expect a turn around time of approximatley 48 hours.
Use ideal body weight for dosing in most cases.
Use adjusted body weight for obese patients (BMI ≥30 kg/m2) Multiple Daily Dose Amikacin 7.5 mg/kg every12 hr IV or IM Once Daily Dose Amikacin (Preferred) 15 mg/kg every 24 hr IV or IM Mycobacteria 7.5-10 mg/kg every 24 hr
No adjustment required
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 species (e.g. M. abscessus).
Monitor creatinine at least 3 times/week. Discontinue if any signs of ototoxicity.
For BID dosing: Target Peak 15-30 mg/L, Trough <5 mg/L. Peak levels usually not required but if drawn, record time of dose and time of level draw as accurately as possible.
Consult pharmacist for level interpretation and dose individualization
For once daily dosing: Target Trough <1 mg/L. Peak levels not recommended.
Less common with once daily dosing
Avoid concomitant nephrotoxins
Greater toxicity with longer duration and supratherapeutic trough levels
Audiology testing required for prolonged use
Increased nephrotoxicity with:
Increased ototoxicity with:
Respiratory paralysis with:
Formal audiology assessment required if planning to use aminoglycoside for >7d or if symptoms develop.
Inform patient of risk of ototoxicity and to report any symptoms.
Antimicrobial class: Aminoglycoside
Pregnancy category: D
Average serum half life: 2.5 hours
Biliary penetration: Moderate
CSF penetration: Poor
Lung penetration: Therapeutic
Urine penetration: Therapeutic