amikacin

Adult Dosing .

Dosage forms:  INJ

infections, bacterial

[conventional interval dosing]

Dose: 7.5 mg/kg/dose IM/IV q12h; Alt: 5 mg/kg/dose IM/IV q8h; Info: use adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts; adjust dose based on serum levels

[extended interval dosing]

Dose: 15-20 mg/kg/dose IV q24h; Info: not indicated in pregnancy, burns, ascites, obesity, neutropenia or endocarditis; use adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts; adjust dose based on random serum levels and nomogram

pneumonia, hospital-acquired or ventilator-assoc.

[15-20 mg/kg/dose IV q24h x7 days]

Info: may extend duration based on clinical response; refer to IDSA guidelines; use adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts; adjust dose based on serum levels

tuberculosis, active (off-label)

[<59 yo, intensive phase]

Dose: 15 mg/kg/dose IM/IV 5-7x/wk; Max: 1 g/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion; adjust dose based on serum levels; use adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts

[<59 yo, continuation phase]

Dose: 15 mg/kg/dose IM/IV 2-3x/wk; Max: 1 g/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion; adjust dose based on serum levels; use adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts

[59 yo and older, intensive phase]

Dose: 10 mg/kg/dose IM/IV 5-7x/wk; Max: 750 mg/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion; adjust dose based on serum levels; use adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts

[59 yo and older, continuation phase]

Dose: 10 mg/kg/dose IM/IV 2-3x/wk; Max: 750 mg/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion; adjust dose based on serum levels; use adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts

endophthalmitis, bacterial (off-label)

[0.4 mg in 0.1 mL sterile water or saline intravitreally x1]

Info: part of multi-drug regimen; refer to institution protocol

renal dosing

[conventional interval dosing]

CrCl 10-50: give usual dose q12-24h; CrCl <10: give usual dose x1, then redose if serum levels <1-2 mg/mL; Info: adjust dose, frequency based on serum levels

HD: give usual dose x1, then redose after dialysis if serum levels <1-2 mg/mL; no supplement; PD: not defined; Info: adjust dose, frequency based on serum levels

[extended interval dosing]

CrCl 30-60: adjust frequency based on random serum levels and nomogram; CrCl <30: avoid extended interval dosing; consider conventional interval dosing

HD: avoid extended interval dosing; consider conventional interval dosing; PD: not defined

[tuberculosis intensive phase]

CrCl <30: give usual dose 2-3x/wk; Info: adjust dose based on serum levels

HD: give usual dose 2-3x/wk after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: not defined; Info: adjust dose based on serum levels

[tuberculosis continuation phase]

renal impairment: not defined; Info: adjust dose based on serum levels

HD/PD: not defined; Info: adjust dose based on serum levels

[endophthalmitis]

renal impairment: not defined

HD/PD: not defined

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  INJ

bacterial infections, neonatal dosing

[<30 wk gestation, 0-7 days old]

Dose: 18 mg/kg/dose IV q48h; Info: adjust dose based on serum levels

[<30 wk gestation, 8-28 days old]

Dose: 15 mg/kg/dose IV q36h; Info: adjust dose based on serum levels

[<30 wk gestation, 29 days old and older]

Dose: 15 mg/kg/dose IV q24h; Info: adjust dose based on serum levels

[30-34 wk gestation, 0-7 days old]

Dose: 18 mg/kg/dose IV q36h; Info: adjust dose based on serum levels

[30-34 wk gestation, 8 days old and older]

Dose: 15 mg/kg/dose IV q24h; Info: adjust dose based on serum levels

[35 wk gestation and older, 0-28 days old]

Dose: 15 mg/kg/dose IV q24h; Info: adjust dose based on serum levels

bacterial infections, conventional interval dosing

[1 mo and older]

Dose: 5-7.5 mg/kg/dose IV q8h; Info: adjust dose based on serum levels; consider using IBW in pts 1 mo and older

tuberculosis, active (off-label)

[intensive phase]

Dose: 15-30 mg/kg/dose IM/IV 5-7x/wk; Max: 1 g/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion; adjust dose based on serum levels

[continuation phase]

Dose: 15-30 mg/kg/dose IM/IV 2-3x/wk; Max: 1 g/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion; adjust dose based on serum levels

renal dosing

[neonatal dosing]

renal impairment: not defined; Info: adjust dose based on serum levels

HD/PD: not defined; Info: adjust dose based on serum levels

[conventional interval dosing]

CrCl 10-50: give usual dose q12-24h; CrCl <10: give usual dose q48-72h; Info: adjust dose based on serum levels

HD: give usual dose x1, then adjust dose based on serum levels; no supplement; PD: not defined

[tuberculosis]

renal impairment: not defined, consider adult renal dosing for guidance

HD/PD: not defined, consider adult renal dosing for guidance

hepatic dosing

[not defined]