AMIKACIN USUALLY SUCCEEDS WHERE OTHER AMINOGL YCOSIDES FAIL

... However, Its Use Should Be Limited To Delay The Emergence Of Resistant Strains Amikacin sulphate ('Amikin'; Bristol) is a new aminoglycoside derived from kanamycin for treating infections caused by susceptible strains of gram-negative bacteria. It acts against a wide range of gram-negative organisms and is synergistic with carbenicillin against many strains of Pseudomonas aeruginosa. The manufacturer recommends it for bacteraemia and infections of the skin and soft tissues, respiratory tract, bones, joints and the CNS caused by sensitive strains.

INPHARMA 27th November, 1976 p3

Only 9% of organisms resistant to kanamycin ('Kanitrex'), gentamicin ('Garamycin') or tobramycin ('Nebcin ')are resistant to amikacin and gram-negative organisms resistant to amikacin are usually resistant to the former three drugs. As bacterial resistance to amikacin has arisen with extensive use, it should be reserved for gram-negative infections resistant to the other aminoglycosides to delay emergence ofamikacin-resistant strains.

Its toxicity is similar to that of kanamycin. Hearing loss is usually mild and may be reversible if the drug is stopped soon enough, but irreversible hearing loss can occur, especially in patients with renal faiiun:. (Tney should receive regular serum level monitoring.) Patients previously treated with other aminoglycosides may have a greater risk of ;totoxicity with amikacin. Caution is needed when patients are also receiving potent diuretics and it is contraindicated with other nephrotoxic or ototoxic antimicrobials.

Medical Letter 18: 97(5 Nov 1976)