Amikacin

Amikacin: Uses, Dosage and Side Effects

Overview

Amikacin is one of Aminoglycosides which inhibits bacterial protein synthesis with a
concentration-dependent mechanism of killing, leading to a marked post-antibiotic effect, allowing prolonged dosing intervals (which may reduce toxicity).

Uses of Amikacin

• Active against many Gram-negative bacteria, Staphylococcus aureus and Nocardia spp., including some that may be resistant to gentamicin.
• Streptococci and anaerobes are usually resistant.
• Amikacin has been used locally in joints and the bladder as specific examples.
• Locally, especially if the site of infection is easily accessible for direct delivery of the drug and if the animal is showing signs of nephrotoxicity.

Dose of Amikacin in Dogs and Cats

Dogs:

15–30 mg/kg i.v, i.m., s.c. q24h.

Cats:

10–15 mg/kg i.v, i.m., s.c. q24h.

Dogs, Cats:

For both dogs and cats, higher doses are for managing sepsis, although there is an increased risk of adverse effects with such high doses.

Side Effects of Amikacin in Dogs and Cats

Nephrotoxic and ototoxic

Contraindications of Amikacin in Dogs and Cats

If possible, avoid use in animals with reduced renal function.

Some Notes:

• Activity at low oxygen sites may be limited.
• Movement across biological membranes may also be limited, hence systemic levels require parenteral administration, and access to sites such as the CNS and ocular fluids is very limited.
• Monitoring serum amikacin levels and renal function should be considered to ensure therapeutic levels and minimize toxicity.
• Intravenous doses should be given slowly, generally over 30–60 minutes. Concurrent fluid therapy is advised.
• Synergism may occur in vivo when aminoglycosides are combined with beta-lactam antimicrobials.
• Aminoglycosides may be inactivated in vitro by beta-lactam antibiotics (e.g. penicillins,
  cephalosporins) or heparin; do not give these drugs in the same syringe.
• It is recommended to avoid administering Amikacin with these drugs due to the occurrence of interactions between each other:
  • Neuromuscular blocking agents (Anesthetics): Can potentiate neuromuscular blockade.
  • Diuretics: increase the nephrotoxic or ototoxic potential of the aminoglycosides.
  • Magnesium sulfate:could increase the risk for neuromuscular blockade.
  • Amphotericin b, cisplatin, polymyxin b, vancomycin: increased risk for nephrotoxicity.
  • NSAIDS:   increased risk for nephrotoxicity.