Selected Antimicrobial Information – Companion Animal
Amikacin [Companion]
Restriction Status
Unrestricted
Dose
| Species | Usage | Dose |
|---|---|---|
| Cats | Extra-label-use | 10-14mg/kg SQ, IM or IV q24h |
| Dogs |
Label dose for susceptible skin/soft tissue infections and UTIs | 10mg/kg SQ or IM q12h (can be used q24h extra-label) |
| For susceptible infections or empirical therapy, including treatment of sepsis | 15mg/kg SQ, IM or IV q24h (extra-label use) |
Brand Name(s)
Amikin®, Amiglyde-V®
Background
Amikacin is a bactericidal, concentration-dependent aminoglycoside antibiotic with efficacy primarily against Gram-negative aerobic organisms, with somewhat less efficacy against Gram-positive aerobes. Many Staphylococcus spp. are susceptible. Amikacin is not effective against anaerobic bacteria and often not efficacious against Streptococcus spp. Oral absorption is poor. Distribution is throughout the extracellular fluid, but may be wider in states of inflammation. Excretion is primarily as active drug in urine. There is a significant post-antibiotic effect.
Acceptable Uses
- Treatment of genitourinary infections, particularly when culture/susceptibility demonstrates resistance to other antimicrobial choices (i.e. Amoxicillin, Trimetoprim-Sulfa).
- Treatment of skin (superficial and deep pyoderma), soft tissue, or orthopedic infections, particularly when culture/susceptibility demonstrates resistance to other antimicrobial choices.
- Treatment of respiratory infections, particularly when culture/susceptibility demonstrates resistance to other antimicrobial choices.
- Treatment of sepsis, bacteremia, or infectious endocarditis. Often used in combination with a penicillin or cephalosporin for broad spectrum coverage.
- As an alternative to gentamicin, particularly in cases of gentamicin resistance or where adverse effects preclude use.
Unacceptable Uses
- Treatment of Gram-positive infections when used alone, unless a culture-confirmed susceptible organism is identified.
- Anaerobic infections.
Formulations Available within the OSU Pharmacy
- Amikacin 1% topical
- Amikacin 250mg/ml injectable suspension
- Amiglyde 50mg/ml intrauterine solution
Notes
- Nephrotoxicity (acute tubular nephrosis) is a significant side effect that can be avoided by following dosing recommendations, minimizing duration of therapy, maintaining hydration status of patient, minimizing use of concurrently nephrotoxic drugs, using topical or local use whenever possible, and/or seeking alternative antimicrobial treatment in patients with pre-existing renal disease. Serum creatinine concentration should be assessed every 1-2 days during treatment. Small changes (i.e. 0.3 mg/dl) in blood creatinine concentration should be regarded as significant and promote reassessment of the treatment. Additionally or alternatively, assessment of total urine production and the production of urine casts should be done every 1-2 days during treatment to determine if renal damage is occurring.
- Ototoxicity is also a significant side effect.
- Cats may be more susceptible to negative side effects than dogs.
- Greyhounds (and other sighthounds) should be dosed at the lower end of the dose range.
