Generic
Amikacin
17 brands available in the market
At a glance
Amikacin is an aminoglycoside antibiotic used for serious Gram-negative bacterial infections. It is effective in septicemia, respiratory tract infections, bone and joint infections, meningitis, skin infections and urinary tract infections.
Description
Amikacin sulfate is a semisynthetic aminoglycoside antibiotic active against Pseudomonas, E. coli, Proteus, Klebsiella, Acinetobacter and Citrobacter species. Strains resistant to gentamicin, tobramycin or kanamycin may be susceptible to amikacin. It is also active against penicillinase-producing and methicillin-resistant Staphylococcus species. It is administered intramuscularly or intravenously with dosage adjusted according to infection severity.
Indications
Bacterial septicemia (including neonatal sepsis); serious respiratory tract infections; bone and joint infections; CNS infections (including meningitis); skin and soft tissue infections; intra-abdominal infections (including peritonitis); burns and postoperative infections; complicated and recurrent UTIs; gentamicin and tobramycin-resistant infections; staphylococcal infections.
Therapeutic class
Aminoglycoside
Pharmacological class
Aminoglycoside Antibiotic
Pharmacology
Amikacin sulfate is a semisynthetic aminoglycoside antibiotic. It binds to the 30S ribosomal subunit of bacteria to inhibit protein synthesis, resulting in stunted bacterial growth and cell death. It also exhibits bactericidal effects by binding to the bacterial cell wall.
Mechanism of action
Amikacin binds to the 30S ribosomal subunit of bacteria, inhibiting protein synthesis, which stops bacterial growth and prevents the spread of infection.
Dosage
Adults and children: 15 mg/kg/day in two equally divided doses (equivalent to 500 mg twice daily in adults).
Neonates and premature children: Initial loading dose 10 mg/kg, then 15 mg/kg/day in two equally divided doses.
Life-threatening or Pseudomonas infections: 500 mg every 8 hours (max 1.5 g/day, max total 15 g).
UTIs (non-pseudomonal): 7.5 mg/kg/day in two equally divided doses (250 mg twice daily in adults).
Renal impairment: Reduce dose or increase dosing interval.
Administration
Intramuscular or intravenous administration (in hospital under medical supervision).
Intraperitoneal use: May be used as an irrigant at 0.25% concentration.
Missed dose
Missed dose is not applicable as it is administered by a doctor in a hospital setting.
Side effects
Common side effects: Increased blood urea, injection site reactions, nausea, vomiting, skin rash, drug fever, headache, paresthesia.
Serious (rare): Hearing loss (tinnitus, vertigo, partial or complete reversible/irreversible deafness), kidney damage, balance disorder, ototoxicity, nephrotoxicity.
Precautions & warnings
- Concurrent use with myorelaxants may cause respiratory arrest
- Avoid combination with other aminoglycosides (increased ototoxicity and nephrotoxicity)
- Increased ototoxicity risk with fast-acting diuretics (in renal failure)
- Increased nephrotoxicity with cephalosporins or polymyxins
- Do not use during pregnancy (fetal ototoxicity risk)
- Ensure adequate hydration during treatment (to minimize kidney damage)
Contraindications
Hypersensitivity to amikacin or any component.
Drug interactions
- Myorelaxants: Potentiated effects; risk of respiratory arrest
- Other aminoglycosides: Increased ototoxicity and nephrotoxicity
- Fast-acting diuretics: Increased ototoxicity risk in renal failure
- Cephalosporins or polymyxins: Increased nephrotoxicity risk
Food interactions
Consuming alcohol does not cause any harmful side effects.
Use in pregnancy
Pregnancy Category: D. Amikacin rapidly crosses the placenta into fetal circulation and there is a potential risk of ototoxicity in the fetus. Use only if clearly needed with medical advice.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
It is not known whether amikacin is excreted in human milk; use with caution.
Pediatric use
Pediatric doses are weight-based (see dosage section above).
Geriatric use
Dose adjustment may be needed for elderly patients (due to reduced renal function).
Renal / hepatic impairment
Renal impairment: Caution required; dose adjustment may be needed. Adjust dose based on creatinine clearance. Ensure adequate hydration.
Hepatic impairment: Probably safe; dose adjustment may not be needed.
Overdose effects
In the event of overdose, peritoneal dialysis or hemodialysis will aid in removal of amikacin from the blood.
Storage conditions
Store below 30°C, protected from light and moisture. Keep out of reach of children.
Chemical structure
C₂₂H₄₃N₅O₁₃ (Molecular weight: 585.6 g/mol)