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
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).
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.
Increased nephrotoxicity with: amphotericin B, cyclosporine, cisplatin, NSAIDS, contrast dye, vancomycin.
Increased ototoxicity: furosemide.
Neuromuscular blockade agents- respiratory paralysis.
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
Urine penetration: Therapeutic
CSF penetration: Poor
Biliary penetration: Moderate