Second-line treatment when other aminoglycosides ineffective
- Mechanism of Action
- Inhibits protein synthesis by binding to the 30s ribosomal subunit, resulting in inaccurate mRNA translation.
- Active against Pseudomonas and most Enterobacteriaciae.
- Gram negative septicaemia
- Directed therapy for severe and susceptible respiratory infections, UTI, skin infections, osteomyelitis or peritonitis
- Adverse Effects
- Nephrotoxicity – reversible, higher risk with poor renal function
- Ototoxicity – irreversible vestibular and auditory dysfunction
- Peripheral neuropathy
- Hypersensitivity reactions
- To ensure therapeutic levels and prevent toxic levels:
- Clinically – monitor for ataxia and hearing loss
- Bloods – monitor serum amikacin levels and creatinine / urea
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