Low
NA
~$400/day
This medication is currently not on hospital formulary - please contact pharmacy if it is needed.
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 <8 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: obtain random amikacin level 6-14 hours after dose and use nomogram to determine appropriate dosing interval.
Toxic levels: Peak greater than 40mg/L, Trough greater than 10mg/L.
Nephrotoxicity (non-oliguric)
Less common with once daily dosing.
Avoid concomitant nephrotoxins.
Greater toxicity with longer duration and supratherapeutic trough levels.
Vestibulocochlear toxicity
Irreversible
Audiology testing required for prolonged use
Other
Increased nephrotoxicity with:
Amphotericin B
Cyclosporine
Cisplatin
NSAIDS
Contrast dye
Vancomycin
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
Urine penetration: Therapeutic
Lung penetration: Therapeutic
CSF penetration: Poor
Biliary penetration: Moderate
