What follows is the old fashioned way to dose amikacin, useful for endocarditis. For once a day dosing and rational click here.
CrCl > 80: 15 mg/kg q 8 - 12 h.
CrCl 80-50: q 8 - 12 h iv.
CrCl 50-10: q 12 - 48 h iv.
CrCl < 10: q 48 h or more.
Hemodialysis: 2.5 mg/kg after hemodialysis.
Peritoneal dialysis: 2.5 mg /kg/day.
Important side effects
Eighth nerve and renal toxicity.
Important drug interactions
Increased nepho and ototoxicty with other oto and nephrotoxic agents.
Rants and Screeds
As with all the aminoglycosides, the classic peak and trough are meaningless. Want to get a maximal peak and a non measurable trough.
By the way, aminolgycosides should probably be used as monotherapy only for urinary tract infections (PubMed).
Treatment of choice
Don't use for
Gram negative aerobes.