amikacin
Amikacin is an aminoglycoside antibiotic that's used to treat several types of bacterial infections in adults and children. It's given as an injection into the veins (IV) or into the muscle (IM) by a healthcare professional. The dosage depends on your age, your weight, and the severity of your infection. Side effects aren't common as long as the level of amikacin in your blood is in a certain range. But they can include diarrhea, nausea, and rash. High amikacin blood levels can lead to more severe risks, such as hearing loss or kidney damage.
What is Amikacin?
What is Amikacin used for?
Sepsis due to a bloodstream infection
Lower respiratory tract infections (e.g., pneumonia, bronchitis)
Brain and spinal cord infections (e.g., meningitis)
Skin infections (e.g., cellulitis)
How Amikacin works
Amikacin is an aminoglycoside antibiotic. It works by preventing bacteria from making certain proteins for growth and survival. This stops the bacteria from growing and spreading.
Drug Facts
What are the side effects of Amikacin?
Common Side Effects
Other Side Effects
- Rash
- Fever
- Headache
- Tingling or "pins-and-needles" feeling
- Tremor
- Nausea
- Vomiting
- Joint pain
- Low blood pressure
- Low magnesium levels
Serious Side Effects
- Side effects related to the nervous system: hearing problems, ringing in the ears, dizziness, numbness, tingling, muscle twitching, difficulty breathing, seizure
- Serious kidney problems: tiredness, dry and itchy skin, low appetite, urinating less than usual, foamy or bloody urine, muscle cramps
- C. difficile-related diarrhea: fever, stomach pain or cramps, foul-smelling diarrhea, frequent bowel movements (up to 15 times per day)
- Serious allergic reaction: hives, rash, swelling of the lips or tongue, difficulty breathing
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
Incidence not known
Agitation
black, tarry stools
bloody or cloudy urine
bluish lips or skin
blurred vision
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chills
coma
confusion
decrease in the amount of urine
decreased urine output
difficulty with breathing
difficulty with moving
dizziness
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
drowsiness
feeling of fullness in the ears
headache
hearing loss
irritability
lethargy
loss of balance
loss or change in hearing
muscle pain or stiffness
muscle twitching
not breathing
pain in the joints
pain in the lower back or side
painful or difficult urination
pale skin
rapid weight gain
ringing or buzzing in the ears
seizures
shakiness in the legs, arms, hands, or feet
shortness of breath
sores, ulcers, or white spots on the lips or in the mouth
stupor
sweating
swelling of the face, ankles, or hands
swollen glands
thirst
trembling or shaking of the hands or feet
trouble with hearing
troubled breathing with exertion
unusual bleeding or bruising
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
Skin rash
vomiting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Amikacin
Pros
Works well to treat many infections caused by Gram-negative bacteria
Approved for adults and children
Cons
Requires your care team to draw your blood often to check your amikacin levels and make sure it's working and is safe for you
Given as an injection
Possible risk for hearing problems and kidney damage
Pharmacist tips for Amikacin
Tell your care team about all of the medications you take, especially if you're taking diuretics (water pills) or other antibiotics. These medications can interact with amikacin and raise your risk for kidney damage and hearing problems.
If your care team says that you don't need to stay in the hospital for treatment, be sure to mark your appointments on your calendar for your doses, any follow-up visits with them, and any lab tests. This will help make sure your amikacin treatment is going well and that the antibiotic is as safe as possible for you. Carefully follow your care team's instructions to help safely fight your infection.
Your care team might order different tests to keep track of your amikacin treatment. These tests help check your amikacin blood levels, kidney health, and hearing. They're important for your infectious disease specialist to decide whether you need dose adjustments to keep the antibiotic working well for you and to keep you safe from side effects.
It's possible for amikacin to cause diarrhea. Most times, diarrhea from treatment goes away when you stop taking the antibiotic. But tell your care team right away if you start having watery or bloody diarrhea, fever, fatigue, or stomach cramps anytime during treatment or after stopping amikacin. These can be signs of infectious diarrhea that can be serious and it needs to be treated right away.
Get medical help right away if you experience any confusion, ringing in the ears, hearing loss, muscle twitching, tingling, or seizure. These could be signs of side effects of the antibiotic that affect your nervous system.
Contact your care team if you develop other symptoms of an illness or if your symptoms become worse. Amikacin can only treat infections caused by bacteria, so it won't help if you have an infection caused by a virus or fungus.
It's important to get all of your amikacin doses as instructed and finish your treatment course, even if you feel better. Otherwise, your infection might get worse or become harder to treat.
Frequently asked questions about Amikacin
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What are the risks and warnings for Amikacin?
Amikacin can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of side effects related to the nervous system, including hearing loss
Risk factors: History of brain, nervous system, or hearing problems | Taking other medications that cause nervous system or hearing problems | Taking too much amikacin | Taking amikacin for too long | Premature and newborn babies | Older age | Dehydration (low fluids in the body)
Amikacin can potentially cause nervous system problems, including dizziness, numbness, tingling, muscle twitching, difficulty breathing, and even seizures. It's also possible for amikacin to cause ringing in the ears or permanent partial or total hearing loss, typically in both ears. Your risk for hearing problems is higher if you're also taking other medications that can cause hearing loss, such as diuretics (e.g., furosemide (Lasix)).
Depending on how long you need amikacin treatment, your care team might test your hearing regularly during treatment. Get medical help right away or contact your care team if you notice changes in your hearing, dizziness, numbness, tingling, or muscle twitching. They can help you manage these effects.
Kidney problems
Risk factors: History of kidney problems | Taking other medications that cause kidney damage | Taking too much amikacin | Taking amikacin for too long | Premature and newborn babies | Older age | Dehydration (low fluids in the body)
Amikacin can potentially damage the kidneys. Sometimes, kidney damage can cause your body to not make urine as well. Your risk is higher if you're also taking other medications that can harm your kidneys.
Your care team will check your kidney health through urine and blood tests while you're getting treated with amikacin. The infectious disease specialist will adjust your dose or stop treatment if it appears that the antibiotic has affected the kidneys.
To protect your kidneys, your care team will be sure to give you IV fluids when you're getting your amikacin injection. They might also recommend that you stay well hydrated during treatment. Contact your care team if you notice signs or symptoms of kidney problems, such as tiredness, dry and itchy skin, low appetite, urinating less than usual, foamy or bloody urine, or muscle cramps.
Risk of harm to unborn baby
It's possible for aminoglycoside antibiotics like amikacin to cause harm to an unborn baby when it's given during pregnancy. This can include hearing loss. Because of the risk of harm, your care team should be aware of whether you're pregnant before your amikacin treatment starts, if possible. Depending on your infection and your risk factors, the infectious disease specialist might consider a different antibiotic for you.
Serious allergic reaction
Risk factors: Allergy to sulfites
Serious allergic reactions to amikacin are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (e.g., closing of the throat). Call for help right away if you notice hives, difficulty breathing, a choking sensation, swelling around your eyes, or swelling of the lips or tongue while you're getting treated with amikacin.
The amikacin injection contains an ingredient called sulfite. Certain people might be sensitive to sulfite and have an allergic reaction to it. Depending on your reaction, the infectious disease specialist might switch you to another antibiotic.
Diarrhea from Clostridioides difficile infection
Antibiotics, including amikacin, raise your risk of getting infected with a bacteria called Clostridioides difficile (C. diff). Antibiotics change the amount of normal bacteria in your stomach and intestines. This can cause C. diff to overgrow in your gut and lead to an infection that causes diarrhea. This diarrhea can sometimes be life-threatening.
C. diff-related diarrhea is a medical emergency. Fet medical attention right away if you experience rapid heart rate, fever, nausea, foul-smelling diarrhea, bloody stools, or frequent bowel movements (even up to 15 times per day). You'll need to get tested for C. diff infection and get treated, if needed.
Development of drug-resistant bacteria
The infectious disease specialist will closely watch your amikacin treatment to make sure you're taking the antibiotic for the appropriate infection and amount of time. Taking amikacin for any shorter or longer periods of time or taking the antibiotic for other illnesses can raise your risk for developing infections caused by drug-resistant bacteria. This puts you at risk of having a severe and life-threatening infection that might be difficult to treat.
Amikacin dosage forms
Typical dosing for Amikacin
Amikacin is given by a healthcare professional as an infusion into the veins (intravenous or IV) or an injection into the muscle (IM).
Amikacin is most commonly given every 8 hours, every 12 hours, or every 24 hours. In some situations, it can be given three times a week.
The infectious disease specialist will find the right dose and treatment schedule for you. It depends on your age, your weight, your kidney function, your infection, and its severity. It also depends on your amikacin blood levels (there's a certain range that it should be between that balances how well the antibiotic works and how safe it is for you).
Interactions between Amikacin and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Ataluren
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alcuronium
- Atracurium
- Cholera Vaccine, Live
- Cidofovir
- Cisatracurium
- Colistimethate Sodium
- Decamethonium
- Doxacurium
- Ethacrynic Acid
- Fazadinium
- Foscarnet
- Furosemide
- Gallamine
- Hexafluorenium
- Lysine
- Mannitol
- Metocurine
- Mivacurium
- Pancuronium
- Pipecuronium
- Rapacuronium
- Rocuronium
- Succinylcholine
- Tubocurarine
- Urea
- Vancomycin
- Vecuronium
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Amikacin contraindications
Allergy to other aminoglycoside antibiotics, like gentamicin or tobramycin
What are alternatives to Amikacin?
Sepsis due to a bloodstream infection
Lower respiratory tract infections (e.g., pneumonia, bronchitis)
Brain and spinal cord infections (e.g., meningitis)
Skin infections (e.g., cellulitis)
Sepsis due to a bloodstream infection
Lower respiratory tract infections (e.g., pneumonia, bronchitis)
Brain and spinal cord infections (e.g., meningitis)
Skin infections (e.g., cellulitis)
Urinary tract infections (UTIs)
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References
Best studies we foundAmerican Academy of Allergy, Asthma, and Immunology. (2024). Sulfite and sulfa drugs.
Bush, L. M. (2024). Overview of gram-negative bacteria. Merck Manual Consumer Version.
Bush, L. M. (2024). Pseudomonas infections. Merck Manual Consumer Version.
Centers for Disease Control and Prevention. (2024). About Acinetobacter.
Centers for Disease Control and Prevention. (2024). About Escherichia coli infection.
Centers for Disease Control and Prevention. (2024). About Pseudomonas aeruginosa.
Colston, J., et al. (2018). Bone and joint infection. Clinical Medicine.
Hikma Pharmaceuticals USA Inc. (2024). Amikacin sulfate- amikacin sulfate injection [package insert]. DailyMed.
Lopez, N., et al. (2011). A comprehensive review of abdominal infections. World Journal of Emergency Surgery.
Norris, A. H., et al. (2018). 2018 Infectious Diseases Society of America Clinical Practice Guideline for the management of outpatient parenteral antimicrobial therapy. Clinical Infectious Diseases.
Pandey, N., et al. (2023). Beta-lactam antibiotics. StatPearls.
Peloquin, C. A., et al. (2004). Aminoglycoside toxicity: Daily versus thrice-weekly dosing for treatment of mycobacterial diseases. Clinical Infectious Diseases.
Sizar, O., et al. (2023). Amikacin. StatPearls.
Someko, H., et al. (2023). Drug fever: A narrative review. Annals of Clinical Epidemiology.
Xu, L., et al. (2022). Therapeutic drug monitoring of amikacin: Quantification in plasma by liquid chromatography-tandem mass spectrometry and work experience of clinical pharmacists. European Journal of Hospital Pharmacy.
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