Amikacin dosage

Newer examples of aminoglycoside antibiotics include amikacin, neomycin (Neosporin, Cortisporin), and tobramycin (TOBI, TobraDex). Injectable tobramycin is used in the treatment of serious infections at many body sites. It has also been formulated in an inhalable dosage form that has a very specific use to treat cystic fibrosis patients having Pseudomonas aeruginosa lung infections. In the form suitable for inhalation by the patient, it delivers the antibiotic directly to the site of infection. 

Strains of multidrug-resistant Mycobacterium tuberculosis, including streptomycin-resistant strains, are usually susceptible to amikacin. Kanamycin-resistant strains may be cross-resistant to amikacin. The dosage of amikacin for tuberculosis is... 

Differences between different aminoglycosides Ototoxicity due to amikacin is primarily cochlear however, in comparisons with equipotent dosages, ototoxicity was of the same order as that caused by gentamicin (14-16). 

De Broe ME, Verbist L, Verpooten GA. Inflnence of dosage schednle on renal cortical accnmnlation of amikacin and tobramycin in man. J Antimicrob Chemother 1991 27(Snppl C) 41-7. 

The variability associated with drug absorption from the gastrointestinal tract can be overcome by using a parenteral preparation (dosage form). It should preferably be administered either by intravenous infusion or slow intravenous injection to avoid circulatory overload. Intraosseous administration is a useful alternative to intravenous injection of some antimicrobial agents (e.g. sodium ampicillin or amoxycillin, cefotaxime, ceftriaxone, gentamicin or amikacin sulphate) in neonatal foals (Fig. 7.1) (Golenz et al, 1994) and puppies (Lavy et al, 1995). This particularly applies when the neonate is in a state of septic shock and/or dehydration. Total plasma protein concentration is an inaccurate index of hydration status unless monitored (repeatedly measured) and interpreted in conjunction with packed cell volume (PCV). 

Sarrubi FA, HuU JH. Amikacin serum concentrations prediction of levels and dosage guidelines. Ann Intern Med 1978 89 612-8. 

Aminoglycosides can be inactivated by various penicillins in vitro and in patients with end-stage renal failure, further complicating dosage recommendations. Amikacin is least affected by this interaction. 

Monitoring of SDD is still in its infancy and quite different from conventional models in that peaks in excess of 20 pg/mL for gentamicin and tobramycin are anticipated. Dosages used varied from 3 to 7 mg/kg/day for gentamicin, tobramycin, and netilmicin and from 14 to 20 mg/kg/day for amikacin. Modification is recommended for increasing dosing interval to every 36 hours for creatinine clearance between 40 and 59 mL/min and to 48 hours for creati-... 

DeBroc ME. Influence of dosage schedules on renal cortical accumulation of amikacin and tobramycin in man. J Antimicobr Chemother 1991 27(supp C) 41-47. 

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