(am i kay’ sin)
PREGNANCY CATEGORY D
Bactericidal: Inhibits protein synthesis in susceptible strains of gram-negative bacteria, and the functional integrity of bacterial cell membrane appears to be disrupted, causing cell death.
Short-term treatment of serious infections caused by susceptible strains of Pseudomonas species, Escherichia coli, indole-positive and indole-negative Proteus species, Providencia species, Klebsiella, Enterobacter, and Serratia species, Acinetobacter species
Suspected gram-negative infections before results of susceptibility studies are known (effective in infections caused by gentamicin- or tobramycin-resistant strains of gram-negative organisms)
Initial treatment of staphylococcal infections when penicillin is contraindicated or infection may be caused by mixed organisms
Treatment of serious infections such as bacterial septicemia (including neonatal sepsis); infections of the respiratory tract, bones, joints, CNS, skin and soft tissues; intra-abdominal infections; postoperative infections; recurrent and complicated UTIs
Unlabeled uses: Aerosolized for the treatment of pneumonia or cystic fibrosis; second-line therapy for drug-resistant tuberculosis
Contraindications and Cautions
Contraindicated with allergy to any aminoglycosides, preexisting hearing loss, myasthenia gravis, parkinsonism, infant botulism, lactation.
Use cautiously with elderly patients, any patient with diminished hearing, renal or hepatic disease, dehydration, neuromuscular disorders, pregnancy.
Injection—50 mg/mL, 250 mg/mL
Adults and pediatric patients
15 mg/kg/day IM or IV divided into two to three equal doses at equal intervals, not to exceed 1.5 g/day. Usual course of treatment is 7–10 days. Uncomplicated infections should respond in 24–48 hr. If no clinical response is seen in 3–5 days, reevaluate therapy.
UTIs: 250 mg bid IM or IV; treatment is usually required for 7–10 days. If treatment is required for longer, carefully monitor serum levels and renal and neurologic function.
Loading dose of 10 mg/kg IM or IV; then 7.5 mg/kg every 12 hr.
Geriatric patients or patients with renal failure
Give normal doses at prolonged intervals or reduced dosage at fixed intervals based on CrCl or serum creatinine levels: CrCl 30–80 mL/min, give 4–12 mg/kg every 24 hr; CrCl 10–30 mL/min, give 4–7.5 mg/kg every 48 hr; CrCl less than 10 mL/min, give 3 mg/kg every 12 hr.