Pharmacological properties of the drug Amikacin
An aminoglycoside antibiotic with a broad spectrum of activity against gram-positive and gram-negative bacteria. Has a bactericidal effect. It is obtained semi-synthetically from kanamycin A. After intramuscular administration, it is quickly absorbed and distributed in the body. It is excreted unchanged in the urine mainly due to glomerular filtration. About 20% of the antibiotic binds to blood plasma proteins. A number of gram-negative microorganisms are sensitive to amikacin, including Pseudomonas spp., E. coli, Proteus spp . (indole-positive and indole-negative strains), Klebsiella spp., Enterobacter spp., Serratia spp., Salmonella spp., Shigella spp., Mima Herellea, Citrobacter freundii, Providencia spp., as well as gram-positive microorganisms ( Staphylococcus spp. and some strains of Streptococcus pneumoniae ). The antibiotic does not affect most anaerobes. Many strains of gram-negative microorganisms resistant to gentamicin may be sensitive to amikacin. Staphylococci resistant to penicillin, methicillin, and some cephalosporins are sensitive to amikacin.
Drug interactions Amikacin
The simultaneous administration of amikacin with anesthetics and muscle relaxants can cause blockade of neuromuscular transmission and paralysis of the respiratory muscles. Do not simultaneously use other ototoxic and/or nephrotoxic drugs, in particular antibiotics such as streptomycin, polymyxin B, neomycin, gentamicin. The simultaneous use of amikacin and fast-acting diuretics, for example derivatives of ethacrynic acid, furosemide, mannitol (especially if the diuretic is administered intravenously), can lead to the development of irreversible deafness. Amikacin should not be mixed with other antibacterial agents in the same volume.
Use of the drug Amikacin
IM or IV. Adults and children are prescribed at a dose of 15 mg/kg body weight per day, dividing the daily dose into 2 administrations. In severe cases and for infections caused by Pseudomonas , the daily dose is divided into 3 administrations. The maximum daily dose is 1.5 g. The maximum course dose should not exceed 15 g. The duration of treatment is usually 3–7 days with intravenous administration and 7–10 days with intramuscular administration. Newborns, including premature infants, are prescribed an initial dose of 10 mg/kg, and then 7.5 mg/kg every 12 hours. When treating patients with impaired renal function, the daily dose should be reduced and/or the intervals between doses should be increased. The dose is reduced depending on the creatinine content in the blood plasma and the patient’s body weight. The interval between antibiotic administrations is calculated by multiplying the plasma creatinine level by 9; for example, if the creatinine level is 2 mg, the drug is prescribed every 18 hours. Administration of amikacin by intravenous infusion to adults and children should be carried out using a volume of fluid sufficient for drip infusion over 30–90 minutes (at a rate of 60 drops per 1 min), and for newborns - 1-2 hours. The concentration of p-ra amikacin when administered intravenously should not exceed 5 mg/ml. IV injection of amikacin should be given very slowly (over 2–7 minutes).
Side effects of the drug Amikacin
Possible albuminuria, hematuria, cylindruria, hyperazotemia and oliguria; manifestations of ototoxicity (partially reversible or irreversible deafness, tinnitus, vestibular disorders), increased activity of liver transaminases and bilirubin concentration in the blood serum, allergic reactions (skin rash, itching, fever, less often - Quincke's edema), changes in the composition of peripheral blood (anemia , leukopenia, granulocytopenia, thrombocytopenia), nausea, vomiting, headache, drowsiness, very rarely - disturbance of neuromuscular transmission.
