C. diff Risk


Oral Bioavailability


Approximate Cost



Traditional Dose Amikacin 7.5 mg/kg q12h IV or IM

Extended Interval Dose Amikacin 15 mg/kg q24h IV or IM

Mycobacteria 7.5-10 mg/kg q24h

Recommend dosing per Pharmacy

Organisms with suspected/documented resistance to gentamicin and tobramycin.

General Information

Common Usage

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 spp (i.e. M. abscessus).

Drug Monitoring


  •  Monitor creatinine at least 2 times/week. Discontinue if any signs of nephro or ototoxicity.

  •  For traditional 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 extended interval dosing: Target Trough <1 mg/L; Peak levels not recommended.


  • Baseline and periodic hearing and vestibular function (questioning audiologic testing with prolonged therapy)

Adverse Effects

  • Nephrotoxicity

  • Auditory toxicity

  • Vestibular toxicity

  • Neuromuscular blockade

Major Interactions

Increased nephrotoxicity with: amphotericin B, cyclosporine, cisplatin, NSAIDS, contrast dye, vancomycin.

Increased ototoxicity: furosemide.

Neuromuscular blockade agents- respiratory paralysis.

Additional Information

Formal audiology assessment if planning to use aminoglycoside for >7d or if symptoms develop

Inform patient of risk of ototoxicity to report any symptoms


Antimicrobial class: Aminoglycoside

Pregnancy category: D

Average serum half life: 2.5 hours

Biliary penetration: Moderate

CSF penetration: Poor

Urine penetration: Therapeutic