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Amikacin

ANTIBIOTICS & ANTIINFECTIVES

AMINOGLYCOSIDES - [ ANTIBIOTICS & ANTIINFECTIVES ]

Amikacin is an aminoglycoside antibiotic. It has activity against aerobic gram negative bacteria like Citrobacter fundii, E. coli, Enterobacter spp, Klebsiella pneumonia, Proteus, Pseudomonas etc. It is available for parenteral use as well as topical use in the form of an inhalation solution and eye drops. (1)

Amikacin sulphate is indicated in the short-term treatment of serious infections due to susceptible strains of Gram-negative bacteria. (1,2,3)

Known hypersensitivity to tobramycin or any aminoglycoside Myasthenia gravis Not indicated in long-term therapy (eg tuberculosis) because of the toxic hazard associated with extended administration. (2)

Vestibular and auditory damage Renal failure, rising BUN, increased blood creatinine, oliguria, proteinuria, nonoliguric azotemia, casts, cells, aminoaciduria, metabolic acidosis, electrolyte wasting, hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia. Neurotoxicity Anemia, granulocytopenia, and thrombocytopenia fever, rash, exfoliative dermatitis, Itching, urticaria Nausea, vomiting, diarrhea Pain at the injection site Hypersensitivity “Malabsorption syndrome” characterized by an increase in fecal fat, decrease in serum carotene, and fall in xylose absorption with prolonged administration. (2,3)

Other nephrotoxic, neurotoxic, ototoxic drugs like penicillins, cephalosporins, clindamycin, vancomycin, polymyxin, amphotericin B, diuretics, platinum compounds, calcineurin inhibitors, NSAIDs. Additive toxicity seen. Cholinergic agents, other neuromuscular blocking agents, and opioid analgesics: Additional neuromuscular blockade. (2)

Dose adjustment required in patients of renal disease, while monitoring serum drug concentrations. Caution advised in those with pre- existing neuromuscular disorders. (2)

Adults, children and older infants with normal renal function: 15 mg/kg/day divided into 2 or 3 equal doses administered at equally divided intervals Neonates: loading dose of 10 mg/kg be administered initially to be followed with 7.5 mg/kg every 12 hours. (2,3)

1 MacDougall C, Chambers H. Aminoglycosides. In: Brunton L, Chabner B, Knollmann B eds. Goodman & Gilman’s The Pharmacological basis of Therapeutics. 12th ed. USA: McGraw Hill; 2011: 1501- 1520. 2 Amikacin. [Online]. [Cited 2013 Aug 29]. Available from: http://www.drugs.com/pro/amikacin.html 3 National Formulary of India. 4th ed. Government of India, Ministry of Health and Family Welfare. India: Indian Pharmacopoeia Commission; 2011.