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Dogs, Cats, Horses
May Be Prescribed by Vets for:
Susceptible Bacterial Infections
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Amikacin is an aminoglycoside antibiotic that is used to treat serious gram-negative bacterial infections. Other antibiotics in this family include gentamicin, streptomycin, neomycin, kanamycin, and tobramycin. Amikacin and gentamicin are the most commonly used in veterinary medicine. The aminoglycoside antibiotics are bactericidal and are particularly effective against aerobic gram-negative bacteria including E. Coli, Proteus, Pseudomonas, Salmonella, Shigella, Serratia, and Enterobacter. There are some gram-positive Staphyloccus that are sensitive to amikacin although generally the aminoglycosides are combined with other antibiotics when both gram-negative and gram-positive bacteria are present. Amikacin has no activity against fungi, or most anaerobic bacteria. Aminoglycosides also have poor activity in the presence of pus or organic debris. Amikacin has a broader spectrum of activity than some of the other members of this group and is often used for bacterial infections resistant to gentamicin.
The mechanism of action for amikacin is through disruption of the bacterial cell wall, irreversible binding of the 30S ribosomal subunit, and inhibition of bacterial protein synthesis. The bactericidal properties of amikacin are concentration dependent and there is significant bactericidal activity even after drug concentrations are below the minimum inhibitory concentration (MIC). Amikacin and other aminoglycosides are eliminated via the kidney and can be nephrotoxic. Animals with decreased kidney function may have a significantly increased half-life.
Aminoglycosides are poorly absorbed from the gastrointestinal (GI) tract and must be given parenterally. Amikacin is also used in topical preparations for the skin, ears and eyes.
Systemic amikacin is used to treat serious gram-negative infections. It is usually given once a day, because it is a concentration dependant antibiotic. Amikacin may be combined with other antibiotics to provide coverage for gram positive bacteria. It is less nephrotoxic than gentamicin although all aminoglycosides have the potential for both renal and otic toxicity. There are a number of factors that increase the risk of nephrotoxicity: see precautions.
Amikacin is frequently used in topical otic-preparations to treat susceptible bacterial infections (most commonly Pseudomonas Aeruginosa). Aminoglycoside antibiotics have poor activity in the presence of pus and cellular debris. Proper cleaning of the ear will increase the effectiveness of topical treatments with amikacin.
Amikacin and other aminoglycosides are commonly used in ophthalmic preparations to treat corneal ulcers. Pseudomonas aeruginosa is the most-common gram-negative bacteria found from ocular cultures. Frequent ophthalmic application appears to be an important factor for treatment success.
Systemic amikacin is used to treat serious gram-negative infections in adult horses and foals. It is frequently used with intravenous penicillins to provide additional gram-positive coverage. Amikacin is generally preferred over gentamicin for systemic use in neonatal foals. The dosing interval in foals can be variable and frequently is much longer than that in adult horses. If renal function or hydration status is questionable, other antibiotics outside the aminoglycoside family may be preferable. Amikacin is also used for ophthalmic preparations, regional limb perfusion, joint lavage, and intra-articular injections.
Plumb's Veterinary Drug Handbook mentions three possible treatments for systemic overdose: hemodialysis, peritoneal dialysis, and complexation using of the penicillins. Articles in the human literature refer to the use of hemodialysis and the importance of aggressive diuresis with intravenous fluids.
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
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