Amikacin – Dose, ROA, MOA, PK, PD, Indications & More

Dose and Dosage: The usual dose of amikacin varies depending on the patient’s age, weight, renal function, and the severity of the infection being treated. For adults, the typical dose for serious infections ranges from 15 to 22.5 mg/kg/day, divided into 2 or 3 equal doses. For pediatric patients, the dosage may range from 15 to 20 mg/kg/day. These doses are typically administered intravenously or intramuscularly.

Frequency: Amikacin is usually administered once daily or divided into multiple doses throughout the day, depending on the severity of the infection and the patient’s renal function.

Route of Administration (ROA): Amikacin is primarily administered intravenously or intramuscularly. It is not intended for oral administration due to poor absorption from the gastrointestinal tract.

Mechanism of Action (MOA): Amikacin is an aminoglycoside antibiotic that inhibits bacterial protein synthesis by binding to the bacterial 30S ribosomal subunit. This inhibitory action interferes with the translation of mRNA, leading to the production of defective proteins and ultimately bacterial cell death.

Pharmacokinetics (PK): After intravenous or intramuscular administration, amikacin is rapidly distributed throughout the body and exhibits a concentration-dependent killing effect. It has a relatively large volume of distribution, indicating extensive tissue penetration. Amikacin is primarily eliminated unchanged in the urine through glomerular filtration, with a half-life ranging from 2 to 3 hours in patients with normal renal function.

Pharmacodynamics (PD): The pharmacodynamic effects of amikacin include its bactericidal activity against a wide range of Gram-negative and some Gram-positive bacteria, including Pseudomonas aeruginosa, Escherichia coli, Klebsiella species, and Enterobacter species. Amikacin’s efficacy is concentration-dependent, and therapeutic drug monitoring may be necessary to optimize dosing and minimize toxicity.

Pathophysiology: Amikacin is indicated for the treatment of serious infections caused by susceptible bacteria, particularly multidrug-resistant Gram-negative pathogens. It is commonly used in hospital settings for infections such as sepsis, pneumonia, urinary tract infections, intra-abdominal infections, and infections caused by Mycobacterium tuberculosis and other atypical pathogens.

Indications: Amikacin is indicated for the treatment of severe infections caused by susceptible bacteria in patients who cannot tolerate or have failed treatment with other antibiotics. It is often reserved for infections caused by multidrug-resistant organisms or for use in combination therapy with other antibiotics.

Contraindications: Amikacin is contraindicated in patients with a known hypersensitivity to the drug or other aminoglycoside antibiotics. It should also be avoided in patients with preexisting auditory or vestibular dysfunction, severe renal impairment, or myasthenia gravis. Caution is advised in patients with neuromuscular disorders or impaired renal function.

Drug Interactions: Amikacin may interact with other medications, particularly those that are nephrotoxic or ototoxic, such as loop diuretics, vancomycin, and cisplatin. Concomitant use of these medications may increase the risk of kidney or ear toxicity. Close monitoring of renal function and hearing is recommended when combining amikacin with other nephrotoxic or ototoxic agents.

Monitoring and Laboratory Tests: Before initiating treatment with amikacin, healthcare providers may perform baseline assessments, including renal function tests, audiometric testing, and baseline cultures to identify the causative pathogen and its susceptibility to amikacin. During treatment, regular monitoring of renal function, hearing, and therapeutic drug levels may be necessary to assess treatment response and detect any potential adverse effects or complications.

Always consult with a healthcare professional for personalized medical advice and recommendations regarding the use of amikacin or any other medications.


Why is this medication prescribed?
Amikacin is prescribed to treat serious bacterial infections caused by susceptible organisms, particularly those resistant to other antibiotics. It is commonly used in hospital settings for infections such as sepsis, pneumonia, urinary tract infections, intra-abdominal infections, and infections caused by multidrug-resistant bacteria.

How should this medicine be used?
Amikacin is typically administered intravenously or intramuscularly by a healthcare professional in a hospital setting. The dosage and duration of treatment depend on the type and severity of the infection, as well as the patient’s age, weight, and renal function.

Other uses for this medicine
In addition to its primary use for bacterial infections, Amikacin may also be used off-label for the treatment of certain other conditions, as determined by a healthcare provider. However, such usage should be under the guidance of a healthcare professional.

What special precautions should I follow?
Before receiving Amikacin, inform your doctor about any allergies you have, especially to antibiotics or other medications. Also, let your doctor know about any medical conditions you have, particularly kidney problems or hearing impairments. Use caution if you are pregnant or breastfeeding, as Amikacin may have potential risks to the fetus or newborn.

What special dietary instructions should I follow?
There are no specific dietary restrictions associated with Amikacin use. However, it’s essential to maintain a balanced diet and stay hydrated, especially during treatment with intravenous antibiotics.

What should I do if I forget a dose?
Since Amikacin is typically administered by a healthcare professional, there is little chance of missing a dose. However, if a dose is missed, it’s essential to follow the instructions of the healthcare provider and receive the next scheduled dose as directed.

What side effects can this medication cause?
Common side effects of Amikacin may include nausea, vomiting, diarrhea, headache, and injection site reactions. More severe side effects may include kidney damage, hearing loss, balance problems, and allergic reactions. Contact your doctor if you experience any unusual or severe side effects while receiving Amikacin.

What should I know about storage and disposal of this medication?
Amikacin is typically stored in a hospital or clinical setting and should be handled and disposed of according to institutional protocols and guidelines. Healthcare providers are responsible for proper storage and disposal of the medication to ensure safety and prevent contamination or misuse.

In case of emergency/overdose
If you suspect an overdose of Amikacin or experience symptoms such as severe dizziness, difficulty breathing, or loss of consciousness, seek immediate medical attention or contact a poison control center right away. Overdose of Amikacin can be serious and requires prompt medical intervention.

Always follow the instructions of your healthcare provider and pharmacist regarding the use, storage, and disposal of Amikacin. If you have any questions or concerns about Amikacin or its use, don’t hesitate to discuss them with your healthcare provider.