Injectable: 50 mg/ml, 250 mg/ml solutions.
Action: Aminoglycosides inhibit bacterial protein synthesis. They are bactericidal and their mechanism of killing is concentration dependent, leading to a marked post-antibiotic effect, allowing prolonged dosing intervals (which may reduce toxicity).
Use: Active against many Gram-negative bacteria, Staphylococcus aureus and Nocardia spp., including some that may be resistant to gentamicin. Streptococci and anaerobes are usually resistant. Its use is only indicated after sensitivity testing has been performed and the organism shown to be resistant to other aminoglycosides such as gentamicin. Activity at low oxygen sites may be limited. Movement across biological membranes may also be limited, hence systemic levels require parenteral administration, and access to sites such as the CNS and ocular fluids is very limited. Monitoring serum amikacin levels should be considered to ensure therapeutic levels and minimize toxicity, particularly in neonates, geriatric patients and those with reduced renal function. Monitoring renal function is also advisable during treatment of any animal. Intravenous doses should be given slowly, generally over 30–60 min. Concurrent fluid therapy is advised.