Indications
Amikacin is a strong antibiotic used in hospital for serious bacterial infections, especially those caused by Gram-negative bacteria that resist other antibiotics. These include blood infections (sepsis), severe chest infections and pneumonia, complicated urinary tract and kidney infections, abdominal infections, bone and joint infections, infections after burns or surgery, and serious infections in newborns. It is also used as part of combination treatment for drug-resistant tuberculosis and some other mycobacterial infections.
How It Works
Amikacin is an aminoglycoside antibiotic. It binds to the part of the bacterial cell (the ribosome) that makes proteins, so the bacteria make faulty proteins and die.
Dosage and Administration
Amikacin is given by injection into a vein (drip) or muscle by a doctor or nurse, usually in hospital. The dose is worked out from body weight and kidney function and is often given once a day. Blood levels and kidney function are checked during treatment, and the dose is adjusted as needed. Treatment usually lasts 7 to 10 days, or longer for tuberculosis, as prescribed.
Interactions
The risk of kidney and hearing damage increases when amikacin is used with other medicines that can harm the kidneys or ears, such as Vancomycin, Colistin, Amphotericin B, Cisplatin, Ciclosporin and strong water tablets like Furosemide. It can increase the effect of muscle relaxants used during anaesthesia. Penicillin-type antibiotics should not be mixed in the same drip bag, as they can inactivate it.
Contraindications
Allergy to amikacin or any other aminoglycoside (such as Gentamicin or Streptomycin), and myasthenia gravis.
Side Effects
The main risks are kidney damage, hearing loss or ringing in the ears, and problems with balance (dizziness, unsteadiness). These are more likely with high doses, long treatment, older age, dehydration or existing kidney disease. Other effects include rash, fever, nausea and pain at the injection site. Rarely, it can weaken breathing muscles.
Get urgent medical help, or tell the nurse at once, if you notice hearing loss, ringing or fullness in the ears, spinning dizziness, much less urine than usual, muscle weakness or difficulty breathing, or swelling of the face, lips or throat.
Pregnancy and Lactation
Aminoglycosides can damage the unborn baby’s hearing, so amikacin is used in pregnancy only for life-threatening infections when no safer option is available. Only small amounts pass into breast milk and are poorly absorbed by the baby; the doctor will decide whether breastfeeding can continue.
Precautions and Warnings
Tell your doctor about kidney disease, hearing or balance problems, Parkinson’s disease, or a family history of hearing loss with aminoglycosides. Drink enough fluids during treatment unless told otherwise. Hearing and kidney tests may be done before, during and after treatment. Hearing damage can sometimes appear after the course has ended; report any change.
Overdose
An overdose can cause kidney damage, hearing and balance problems, and breathing difficulty. It is managed in hospital, sometimes with dialysis to remove the medicine.
Therapeutic Class
Aminoglycoside antibiotic.
Storage
Store below 30°C, away from light and out of the reach of children. Hospital staff store and prepare the injection.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.