Enter intramuscularly (in / m) and intravenously (intravenously) drip.
Adults and children older than 1 month 5 mg / kg every 8 hours or 7.5 mg / kg every 12 hours. The maximum daily dose is 15 mg / kg / day, but not more than 1.5 g / day.
For treatment of uncomplicated urinary tract infections in adults, 250 mg IM is administered every 12 hours.
In newborns treatment starts with the introduction of an initial (loading) dose of 10 mg / kg, then administered at 7.5 mg / kg every 12 hours.
The duration of treatment is, on average, 7-10 days.
Table 1 presents the doses of amikacin in children and adults, depending on the mode of administration chosen.
Table 1.
| Body weight, kg | Dosing regimen |
| 7.5 mg / kg every 12 hours | 5 mg / kg every 12 hours |
| 45 | 337.5 mg | 225 mg |
| 50 | 375 mg | 250 mg |
| 55 | 412.5 mg | 275 mg |
| 60 | 450 mg | 300 mg |
| 65 | 487.5 mg | 325 mg |
| 70 | 525 mg | 350 mg |
| 75 | 562.5 mg | 375 mg |
| 80 | 600 mg | 400 mg |
| 85 | 637.5 mg | 425 mg |
| 90 | 675 mg | 450 mg |
| 95 | 712.5 mg | 475 mg |
| 100 | 750 mg | 500 mg |
Dosing in patients with impaired renal function
There are the following ways to correct the dosing regimen in patients with impaired renal function:
1) it is possible to increase the interval between the administration of medium doses of amikacin,which is determined by the formula: interval (h) = concentration of creatinine (mg / 100 ml) x 9; for example, at a serum creatinine concentration of 2 mg / 100 ml, 7.5 mg / kg administered every 18 hours;
2) for the selection of a dose of amikacin administered at a fixed time interval are guided by the therapeutic monitoring data; here Cmah, measured 60 minutes after IM or after IV infusion, should not exceed 35 μg / ml; if it is not possible to determine the concentration of amikacin in the blood serum, the treatment starts with the usual therapeutic dose of 7.5 mg / kg as a loading dose; the maintenance dose is calculated in accordance with the creatinine clearance according to the formula
supportive dose = Creatinine clearance in the patient, ml / min / Creatine clearance is normal, ml / min X The loading dose, mg / kg
and administered every 12 hours.
Rules for the preparation of solution and administration
To prepare a solution for the / m introduction, the contents of the vial are dissolved in 2-3 ml of water for injection. Enter deeply intramuscularly into areas of the body with a pronounced muscular layer (upper-outer quadrant of the buttock or lateral surface of the thigh). It is recommended that an aspiration test be carried out to avoid undesirable introduction of the solution into the blood vessel.
To prepare a solution for IV infusion, the contents of the vial are dissolved in 3-5 ml of water for injection. The resulting solution is transferred to 100-200 ml of a compatible infusion medium - 0.9% sodium chloride solution, 5% dextrose solution, an aqueous solution containing 5% dextrose and 0.2% sodium chloride, an aqueous solution containing 5% dextrose and 0, 45% sodium chloride, Ringer's lactate solution, Normosol M solution or Plasma-Lit solution 148. The concentration of amikacin in the solution for intravenous administration should not exceed 5 mg / ml. Enter in / in the drip for 30-60 minutes. In children, the volume of injected fluid should be reduced depending on the dose of the antibiotic. The duration of IV infusion in infants is 1 -2 hours.