Low
NA
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 closely (Pharmacist may order per MSH Policy).
Discontinue if any signs of ototoxicity.
Pharmacist will consult, adjust doses and order serum drug levels and renal function monitoring as per MSH Policy.
For indication specific peak and trough target levels, please refer to MSH Aminoglycoside Policy and consult pharmacy.
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
Biliary penetration: Moderate
CSF penetration: Poor
Lung penetration: Therapeutic
Urine penetration: Therapeutic
