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Amcin

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Indications:

This medicine is active against a broad spectrum of Gram-negative (Pseudomonas, Escherichia coli, indole-positive and indole-negative Proteus, Salmonella and Shigella, Klebsiella, Enterobacter, serratia, Providencia, Citrobacter) and against several Gram-positive germs (Staphylococcus aureus producing and not producing penicillinase, including methicillin-resistant strains, Enterococci, Sreptococcus pyogenes and Diplococcus pneumoniae). Amikacin is not degraded by most enzymes inactivating other aminoglycosides, therefore microorganisms resistant to gentamicin, tobramycin and kanamycin are susceptible to Amikacin. Amikacin is therefore indicated in short treatments of severe infections caused by strains which are susceptible; namely: bacteriemia and septicemia (including neonatal sepsis); complicated and recurrent infections of the genito-urinary tracts; infections of the respiratory tract, of the osteoarticular apparatus, of the central nervous system (including meningitis); infections of the gastrointestinal tract (including peritonitis); burns and postoperative infections. Amikacin can be used as the antibiotic of first choice in suspected Gram-negative infections, even before obtaining results of microbiological analysis. Amikacin is quickly absorbed after parenteral administration, and bactericidal serum concentrations are maintained for 10 – 12 hours.

Contraindications:

A history of hypersensitivity to Amikacin is a contraindication for its use. A history of hypersensitivity or serious toxic reactions to aminoglycosides may contraindicate the use of any other aminoglycoside because of the known cross-sensitivities of patients to drugs in this class.

Adverse reactions:

All aminoglycosides have the potential to induce auditory, vestibular, and renal toxicity and neuromuscular blockade. They occur more frequently in patients with present or past history of renal impairment, of treatment with other ototoxic or nephrotoxic drugs, and in patients treated for longer periods and/or with higher doses than recommended. Neurotoxicity-Ototoxicity: Toxic effects on the eighth cranial nerve can result in hearing loss, loss of balance, or both. Amikacin primarily affects auditory function. Cochlear damage includes high frequency deafness and usually occurs before clinical hearing loss can be detected. Neurotoxicity-Neuromuscular Blockade: Acute muscular paralysis and apnea can occur following treatment with aminoglycoside drugs. Nephrotoxicity: Elevation of serum creatinine, albuminuria, presence of red and white cells, casts, azotemia, and oliguria have been reported. Renal function changes are usually reversible when the drug is discontinued. In addition to those described above, other adverse reactions which have been reported on rare occasions are skin rash, drug fever, headache, paresthesia, tremor, nausea and vomiting, eosinophilia, arthralgia, anemia, and hypotension.

Interactions:

Concurrent use of cephalosporins may increase the risk of nephrotoxicity. Concurrent use of frusemide may increase the risk of ototoxicity. Amikacin should not be given to patients taking neuromuscular blocking agents.

Warnings:

Patients treated with Amikacin should be under close clinical observation. Amikacin should be administered separately and should not be mixed with other agents in syringes. Amikacin should be discontinued immediately if a symptoms of ototoxicity appears. Amikacin should be given with caution to elderly patients, infants, patients with neuromuscular disturbances or patients with renal failure who require reduced doses.

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Consultants Corner

Dr. Talal Sabouni

Dr. Talal Sabouni UROLOGY AND KIDNEY TRANSPLANT

Samir Moussa M.D.

Samir Moussa M.D. ENT Specialist

Dr. Samer Al-Jneidy

Dr. Samer Al-Jneidy Pediatrician

Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

Dr. Faisal Dibsi

Dr. Faisal Dibsi Specialist of Otolaryngology - Head and Neck Surgery

Yaser Habrawi , F.R.C.S.Ed

Yaser Habrawi , F.R.C.S.Ed Consultant Ophthalmologist

Dr . Dirar Abboud

Dr . Dirar Abboud Hepatologist – Gastroenterologist

Dr. Hani Najjar

Dr. Hani Najjar Pediatrics, Neurology
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