Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.
Cystic fibrosis pulmonary infection: 30 mg/kg/DAY divided q8-24h (extended interval preferred).
Treatment of Nontuberculous Mycobacterial Infections: 15- 30 mg/kg/DAY divided q12-24h; maximum 1.5 g/DAY
15- 22.5 mg/kg/DAY divided q8h; maximum 1.5 g/DAY
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 urine output, urinalysis, BUN, serum creatinine, peak and trough amikacin concentrations. Discontinue if any signs of ototoxicity.
Serum level monitoring for conventional dosing: Draw peak levels 30 minutes after the end of the infusion and trough levels within 30 minutes before the next dose. UTI: Peak levels 15-20 mcg/mL and trough < 4 mg/L (if level monitoring is indicated), Serious infections: Peak 20-40 mg/L and trough < 8 mg/L,.
Serum level monitoring for extended-interval dosing: Target trough <2 mg/L; Peak levels not generally recommended.
Consult pharmacist for level interpretation and dose individualization
Nephrotoxicity (non-oliguric)- greater toxicity with longer duration and supratherapeutic trough levels; avoid concomitant nephrotoxins
Vestibulocochlear toxicity (irreversible)- greater risk with prolonged use, sugest audiology testing if prolonged use
Can exacerbate neuromuscular blockade- e.g. contraindicated in patients with myasthenia gravis.
Enhanced nephrotoxic effect with concomitant use of other nephrotoxins .
Enhanced ototoxicity with loop diuretics (e.g. furosemide). <br> Non-depolarizing muscle relaxants may be potentiated.
Antimicrobial class: Aminoglycoside
Average serum half life: Neonates (birth weight <2kg):
PNA 1 to 3 days of age: 7.1 hours
PNA 4 to 7 days of age: 6.1 hours
PNA >7 days of age: 5.5 hours.
Neonates(birth weight >2kg):
PNA 1 to 4 days of age: 6.5 hours
PNA 4 to 7 days of age: 5.1 hours
PNA >7 days of age: 4.9 hours
Infants ≥20 days: 2.21 ± 0.15 hours.
Children <6 years: 2.04 ± 0.2 hours.
Children and Adolescents 4 to 16 years: 1.6 ± 0.4 hours
Route of Elimination: Urine (94% to 98%); excreted unchanged via glomerular filtration within 24 hours