Amikacin

It is semisynthetic aminoglycoside virtually identical to its parent compound Kanamycin. Amikacin is effective against a variety of aerobic gram-negative bacilli including those that are resistant to Gentamicin and other aminoglycosides. (Escherichia coli, Pseudomonas aeruginosa, indole positive and negative Proteus species Klebsiella, Enterobacter, Serratia, Acinetobacter, Citrobacter Freundii and Providencia stuartii). It is effective against both penicillinase and non-penicillinase producing Staphylococcus aureus. Amikacin shows excellent activity against Mycobacterium tuberculosis and atypical Mycobacteria.

Indications

Bacteraemias, septicaemias, respiratory tract, bones and joints, CNS( including meningitis), Skin, Soft tissue, intra-abdominal infections (including peritonitis), burns and post-operative infections.

Dosage

i.m route For adults, Children and older infants 15 mg/kg body wt/day in 2 or 3 divided doses. Max of 1.5 gm/day. Neonates 10 mg/kg body wt followed by 7.5 mg/kg every 12 hours. I.V. route dosage is identical, injection spread over 2-3 mins or a slow i.v infusion spread over a period of 30-60 mins and for infants and neonates 1-2 hours.

Contra-Indications

Known hypersensitive to aminoglycoside.

Special Precautions

Impaired renal function, Ensure adequate hydration. Paediatrics: Use with caution. Pregnancy: Contraindicated. Lactation: Contraindicated. Elderly: Use with caution.

Side Effects

Ototoxicity, nephrotoxicity, Neuromuscular blockade, Skin rash, tremors, eosinophilia, headache, nausea, vomiting.

Drug Interactions

Increased ototoxic or nephrotoxic effects with ethacrynic acid and neuro-muscular blocking drugs. Potentiates actions of penicilline, cephalosporine and newer Beta-lactum antibiotics.