Amikacin: Effects, Uses & Risks

Amikacin is used as an antibiotic against various diseases of the respiratory tract, against complaints in the abdomen and also against infections of the kidney or in burn wounds and meningitis. It is usually an easily tolerated antibiotic that has few common side effects.

What is amikacin?

Amikacin is used as an antibiotic, for example, against various diseases of the respiratory tract, against complaints in the abdomen and also against infections of the kidney. Amikacin belongs to the group of antibiotics based on aminoglycoside and acts exclusively against aerobic and gram-negative bacteria. It is usually administered intravenously or directly intramuscularly, there is only one exception in tablet form. Thus, it is also the only aminoglycoside that is administered in any other form at all (outside of injections). Amikacin is generally well tolerated and can be given to middle-aged people as well as seniors.

Pharmacologic Action

As an antibiotic, amikacin acts exclusively against certain bacteria and should not cause direct effects on individual organs, except for side effects. Once administered, the aminoglycoside-based drug attempts to interfere directly with the so-called protein biosynthesis of the infected bacteria. This synthesis is inhibited by amikacin and the formation of new proteins, which are necessary for metabolism, is completely prevented by the active substance. Infected bacteria are thus no longer viable and also unable to multiply. Over a relatively short period of time, this should lead to the death of all infected bacteria. Of the actual active ingredient in Amikacin, only about 11% enters the [[bloodstream]], where it binds directly to plasma proteins. The “lifetime” of this plasma is three hours. During this time, amikacin exerts the described effect. Afterwards, the active ingredient is usually completely excreted in the urine, so no residues remain within the patient’s body. How long treatment with amikacin lasts depends on the severity of the disease and therefore varies from patient to patient.

Medical application and use

Amikacin is almost always administered intravenously or intramuscularly. There are only a few preparations which are delivered orally or by other means. The drug itself is used for a variety of different diseases: Primarily, amikacin serves as a treatment for respiratory infections caused by bacteria, and it can also combat various infections in the abdomen (such as peritonitis in common cases). Mild to moderate burn wounds are also among the antibiotic’s uses. In mild to moderate cases of meningitis or endocarditis, amikacin can also produce improvement in symptoms. Amikacin is also used for septic infections of the kidney and the entire genitourinary system when other drugs specifically designed for these organs do not provide relief. In cases of generalized bacteremia or sepsis, amikacin is also used. Amikacin has no off-label uses to the best of our current knowledge. Also, the drug should not be used in newborns or premature infants or if hypersensitivity to certain aminoglycoside-based antibiotics is prevalent. During pregnancy and lactation, the administration of amikacin is also not recommended, because in this way (breast milk) the child may also come into contact with the active substance.

Risks and side effects

Common side effects of amikacin include various gastrointestinal tract disorders, which particularly include a persistent feeling of nausea and, as a result, vomiting. Furthermore, administration of the drug may cause moderate headache and impaired hearing. Temporary kidney damage is one of the side effects of amikacin, as is peripheral nerve damage. Less common are also breathing problems and persistent convulsions and muscle twitching. Furthermore, some interactions with other drugs are known: The aforementioned deterioration of hearing may be exacerbated if cytostatic drugs containing platinum or loop diuretics are administered in addition to amikacin.Patients taking muscle relaxants also complain of a significantly prolonged (adverse) duration of action of the drug when taking amikacin concomitantly.