Amikacin is an aminoglycoside

Aminoglycoside

An aminoglycoside is a molecule or a portion of a molecule composed of amino-modifiedsugars.Several aminoglycosides function as antibiotics that are effective against certain types of bacteria...

 antibiotic

Antibiotic

An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...

 used to treat different types of bacteria

Bacteria

Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...

l infection

Infection

An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

s. Amikacin works by binding to the bacterial 30S

30S

30S is the smaller subunit of the 70S ribosome of prokaryotes. It is a complex of ribosomal RNA and ribonucleoproteins that functions in mRNA translation...

 ribosomal

Ribosome

A ribosome is a component of cells that assembles the twenty specific amino acid molecules to form the particular protein molecule determined by the nucleotide sequence of an RNA molecule....

 subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize protein

Protein

Proteins are biochemical compounds consisting of one or more polypeptides typically folded into a globular or fibrous form, facilitating a biological function. A polypeptide is a single linear polymer chain of amino acids bonded together by peptide bonds between the carboxyl and amino groups of...

s vital to its growth.

Administration

Amikacin may be administered once or twice a day but must be given by the intravenous or intramuscular route. There is no oral form available as amikacin is not absorbed orally. In people with kidney failure, dosage must be adjusted according to the creatinine clearance, usually by reducing the dosing frequency.

Uses

Amikacin is most often used for treating severe, hospital-acquired infections with multidrug resistant

Multidrug resistance

Multiple drug resistance or Multidrug resistance is a condition enabling a disease-causing organism to resist distinct drugs or chemicals of a wide variety of structure and function targeted at eradicating the organism...

 Gram negative bacteria such as Pseudomonas aeruginosa

Pseudomonas aeruginosa

Pseudomonas aeruginosa is a common bacterium that can cause disease in animals, including humans. It is found in soil, water, skin flora, and most man-made environments throughout the world. It thrives not only in normal atmospheres, but also in hypoxic atmospheres, and has, thus, colonized many...

, Acinetobacter

Acinetobacter

Acinetobacter [asz−in−ée−toe–back−ter] is a genus of Gram-negative bacteria belonging to the Gammaproteobacteria. Acinetobacter species are non-motile and oxidase-negative, and occur in pairs under magnification....

, and Enterobacter

Enterobacter

Enterobacter is a genus of common Gram-negative, facultatively-anaerobic, rod-shaped bacteria of the family Enterobacteriaceae. Several strains of the these bacteria are pathogenic and cause opportunistic infections in immunocompromised hosts and in those who are on mechanical ventilation...

. Serratia marcescens and Providencia stuartii

Providencia stuartii

Providencia stuartii , is a Gram negative bacterium that is commonly found in soil, water, and sewage. P. stuartii is the most common of the 5 species found in the genus Providencia, with Providencia rettgeri, Providencia alcalifaciens, Providencia rustigianii, P heimbachae...

 are also included in the spectrum. Amikacin can also be used to treat non tubercular mycobacterial infections and tuberculosis (if caused by sensitive strains) when first line drugs fail to control the infection.

Amikacin may be combined with a beta-lactam antibiotic

Beta-lactam antibiotic

β-Lactam antibiotics are a broad class of antibiotics, consisting of all antibiotic agents that contains a β-lactam nucleus in its molecular structure. This includes penicillin derivatives , cephalosporins , monobactams, and carbapenems...

 for empiric therapy

Empiric therapy

Empiric therapy is a medical term referring to the initiation of treatment prior to determination of a firm diagnosis. It may be thought of as taking the initiative against an anticipated and likely cause of infectious disease. It is most often used when antibiotics are given to a person before the...

 for people with neutropenia

Neutropenia

Neutropenia, from Latin prefix neutro- and Greek suffix -πενία , is a granulocyte disorder characterized by an abnormally low number of neutrophils, the most important type of white blood cell...

 and fever

Fever

Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...

.

Resistance

Amikacin has high resistance against bacterial inactivation. It resists attacks by most bacterial inactivating enzymes, this is accomplished by the L-hydroxyaminobuteroyl amide (L-HABA) moiety attached to N-3 which inhibits acetylation, phosphorylation and adenylation in the distant amino sugar ring (C-2,C-3,C-4). To prevent the development of bacterial resistance to this extremely powerful antibiotic, its use is tightly regulated.

Side effects

Side effects of amikacin are similar to other aminoglycosides. Kidney damage

Nephrotoxicity

Nephrotoxicity is a poisonous effect of some substances, both toxic chemicals and medication, on the kidneys. There are various forms of toxicity. Nephrotoxicity should not be confused with the fact that some medications have a predominantly renal excretion and need their dose adjusted for the...

 and hearing loss

Ototoxicity

Ototoxicity is damage to the ear , specifically the cochlea or auditory nerve and sometimes the vestibular system, by a toxin. It is commonly medication-induced; ototoxic drugs include antibiotics such as the aminoglycoside gentamicin, loop diuretics such as furosemide, and platinum-based...

 are the most important effects. Because of this potential, blood levels of the drug and markers of kidney function (creatinine

Creatinine

Creatinine is a break-down product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body...

) may be monitored. Moreover, doses are adjusted specifically based upon serum Creatinine clearance in clinical settings.