Intramuscularly (in / m), intravenously (iv) (drip for 30-60 minutes).
Adults and children over 6 years of age - 5 mg / kg every 8 hours or 7.5 mg / kg every 12 hours; bacterial urinary tract infections (uncomplicated) - 250 mg every 12 hours; after the hemodialysis session, an additional dose of 3-5 mg / kg may be prescribed. The maximum dose for adults is up to 15 mg / kg / day, but not more than 1.5 g / day for 10 days.
The duration of treatment with iv introduction is 3-7 days, with a / m - 7-10 days. Preterm neonates with an initial dose of 10 mg / kg, then 7.5 mg / kg every 18-24 hours; newborns and children under 6 years of age, the initial dose is 10 mg / kg, then 7.5 mg / kg every 12 hours for 7-10 days.
Patients with burns may need a dose of 5-7.5 mg / kg every 4 to 6 hours due to shorter T1/2 (1-1.5 h) in these patients.
For the / m introduction, use a solution prepared by adding 2-3 ml of water for injection to the contents of the vial (250 mg or 500 mg) and for the dosage of 1000 mg - 4-5 ml of water for injection.
For IV injection (drip), the contents of the vial are dissolved in 200 ml of a 5% solution of dextrose (glucose) or 0.9% sodium chloride solution. The concentration of amikacin in the solution for IV drip administration should not exceed 5 mg / ml.
In children, the volume of injected fluid should be reduced depending on the dose of the antibiotic. The duration of IV in the introduction of newborns is 1-2 hours.
Patients with renal failure require a correction of the dosing regimen: a dose reduction or an increase in the interval between administrations is necessary.
In the case of an increase in the interval between administrations (if the level of creatinine clearance is not known and the patient's condition is stable), the interval between doses is set as follows:
Interval (hours) = serum creatinine concentration x 9.
If the serum creatinine concentration is 2 mg / 100 ml, the recommended single dose (7.5 mg / kg) should be administered every 18 hours.
When the interval is increased, the single dose is not changed.
In the case of a single dose reduction with unchanged dosing regimen, the first dose for patients with renal insufficiency is 7.5 mg / kg.
To calculate the subsequent doses, it is necessary to separate the creatinine clearance value (ml / min) in patients for creatinine clearance in norm, then multiply the obtained figure by the amount of the initial dose in mg, ie:
The subsequent dose (mg), administered every 12 hours = Creatinine clearance, revealed in the patient (ml / min) / Creatinine clearance normal (ml / min) initial dose (mg)