Amikacin
Guidelines for Use
Indication for Use:
1. Culture and
sensitivity proves isolated organism responsible for a clinical infection
which is resistant or only moderately sensitive to gentamicin or tobramycin.
2. Empirical in presumed infections in patient either
currently on or recently on another aminoglycoside or with nosocomial
infection in a hospital area with high frequency of gentamicin resistance. If
culture proves sensitive to gentamicin or tobramycin, switching is
recommended.
3. Combination therapy with ticarcillin in renally impaired
patients.
Dose:
15 mg/kg/day in 2 or 3 doses. Not to exceed 1.5 grams/day for
any adult.
Modify in renal failure. Conform to MIC of organism.
Monitor:
Serum creatnine obtained before therapy or within 24 hours of
initiation of therapy.
Serum creatnine obtained
twice weekly during therapy. If 2mg/dl, then every other day.
Blood levels — peak and
trough — if patient treated for longer than 72 hours. If dose adjusted —
draw levels again in 48 hr. — repeat every 4-7.
Adverse Reactions:
— decreased renal function, ototoxicity, hypersensitivity.
Outcome:
Clinical improvement noted in progress notes
Defervesence within 72 hours.
