Appropriate amikacin dose depends on a patient’s weight, condition, and response to this aminoglycoside antibiotic. The drug is delivered by injection and may be recommended for critically ill patients with severe infections. It can also be used in some types of surgeries, like orthopedic procedures, where it may be added to irrigation fluid to clean the site of an injury. Risks can include damage to the kidneys as well as neurological complications, and patients need to be monitored while on amikacin.
A standard amikacin dose starts at 15 milligrams per kilogram of the patient’s body weight, delivered in divided doses over the course of the day. Higher dosing may be required for severe infections, generally not exceeding 22.5 milligrams per kilogram. Patients with compromised kidneys may need a dosage adjustment, like smaller doses at more frequent intervals to give the body more time to process the medication.
The medical provider administering amikacin may request periodic tests to check serum levels. A blood sample can be used to determine how much medication is circulating in the blood. If the patient’s blood has a high concentration, it may be necessary to step the dose down. Low concentrations indicate the patient may need a higher amikacin dose to experience the benefits of the medication. These checks also provide an opportunity to look for signs of complications like abnormal kidney function.
If a patient starts to experience kidney problems on the medication, a medical professional can reevaluate to determine how to proceed. Neurological issues can also be a cause for concern; symptoms like altered level of consciousness and slowed respiratory rate may be indicators of a bad reaction. The patient could need a lower amikacin dose, or a different medication entirely, to protect the nervous system.
People with a history of bad reactions to aminoglycoside antibiotics should mention this if a medical provider recommends amikacin. Severe allergies should be noted on a medic alert card so that in the event someone is unconscious or unable to communicate, the information will still be available to care providers. In hospital settings, there may be a procedure nurses must follow before administering the drug, including confirming the patient’s identity and the dose and checking to see when the last amikacin dose was administered. This reduces the risk of endangering the patient. Patients can ask questions before medication is administered if they aren’t sure why they are receiving a drug or have concerns about errors.