II. Indications
- Gram Negative Infections
- Cystic Fibrosis respiratory exacerbation
- Tuberculosis (second-line agent)
III. Mechanism
- See Aminoglycoside
- Amikacin is derived from Kanamycin
IV. Dosing
-
Gram Negative Infections in Adults and Children (FDA Approved dosing)
- Give 15 mg/kg/day (max 1500 mg/day) IM or IV divided every 8 to 12 hours
- Once daily 15 mg/kg dose is used off-label
-
Gram Negative Infections in Newborns (age <1 month)
- Give 10 mg/kg IM or IV load, then 7.5 mg/kg IM or IV every 12 hours
-
Cystic Fibrosis Respiratory Exacerbation
- Give 30 to 35 mg/kg IV every 24 hours and adjust dose based on levels
- Target peak 80 to 120 mcg/ml
- Target trough <10 mcg/ml
V. Adverse Effects
- See Aminoglycoside
-
Aminoglycosides are associated with risk of Ototoxicity and nephrotoxicity (FDA black box warning)
- See Aminoglycoside for risk factors
VI. Safety
- Pregnancy Category D
- Considered safe in Lactation
VII. Resources
- Amikacin Injection Solution (DailyMed)
VIII. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Sizar (2023) Amikacin, StatPearls, Treasure Island, FL