Neonatal Drug Therapy Manual

Amikacin

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Updated March 5, 2024 - 2:30pm

Alternate Name(s): 
Amikin
Classification: 
Antibiotic (aminoglycoside)
Original Date: 
March 1992
Revised Date: 
December 2020
Indications: 
  • Gram (-) organisms resistant to other antibiotics
Administration: 
  • IV intermittent infusion: over 30 minutes
Dosage: 

< 1.2 kg:

  • (0 - 4 weeks): 7.5 mg/kg/dose Q18-24H

1.2 - 2 kg:

  • (0 - 7 days): 7.5 mg/kg/dose Q12-18H
  • (> 7 days): 7.5 mg/kg/dose Q8-12H

> 2 kg:

  • (0 - 7 days): 10 mg/kg/dose Q12H
  • (> 7 days): 10 mg/kg/dose Q8H
Side Effects: 
  • Dermatologic: rash
  • Hematologic: anemia, eosinophilia, leukopenia
  • Neuromuscular & skeletal: increased neuromuscular blockade when used with other neuromuscular blocking agents
  • Otic: ototoxicity
  • Renal: nephrotoxicity
Parameters to Monitor: 
  • Renal: serum creatinine, urea, urine output
  • Therapeutic drug levels:
    • Trough (0 - 30 minutes before dose due): < 5 mg/L
    • Peak (30 minutes after the end of a 30 minutes infusion): 20 - 30 mg/L

** When checking level, administer next dose as scheduled. Do not wait for levels to be reported unless otherwise advised

Reconstitution and Stability: 

CHEO:

  • Amikacin 250 mg/mL
    • Take 1 mL (250 mg) and add to 24 mL D5W
    • Final concentration: 10 mg/mL

TOH:

  • Amikacin 250 mg/mL
    • Take 1 mL (250 mg) and add to 49 mL D5W
    • Final concentration: 5 mg/mL
Compatibility: 

- Solutions Compatible: dextrose, 0.45% NaCl, 0.9% NaCl, dextrose-saline combinations

- Y-site Compatible: acyclovir, cloxacillin, dexmedetomidine, fluconazole, furosemide, hydromorphone, midazolam, morphine, piperacillin-tazobactam, vancomycin

Incompatible: amphotericin B, heparin

** Due to the potential inactivation of aminoglycosides and antibiotics such as penicillins and cephalosporins, it is preferable to separate administration of these antibiotics by 30 - 60 minutes

References: 

-Taketomo CK, Hodding JH, Kraus DM.  Pediatric Dosage Handbook 22nd Edition.  Hudson: Lexi-Comp Inc.;2015

- American Society on Health-System Pharmacists (ASHP).  Handbook on injectable Drugs. 19th Edition. Bethesda: ASHP 2017

 

 

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