Amikacina Sulfato
Amikacin Sulfate
Amikacin sulfate
También conocido como: Amikin · Amiglyde-V · amikacin sulphate · amikacini sulfas · BB-K8
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Susceptible infections | 15 mg/kg IV q24h or 20 mg/kg SC/IM q24h. In Greyhounds (and potentially other sighthounds) reduce dose to 10 mg/kg IV q24 or 15mg/kg SC/IM q24h. | IV/SC/IM | q24h | — | 🌎 NA |
| Susceptible infections | 15 mg/kg (route not specified) once daily (q24h). Neutropenic or immunocompromised patients may still need to be dosed q8h (dose divided). | Not specified | q24h (or q8h) | — | 🌎 NA |
| Sepsis | 20 mg/kg once daily IV | IV | q24h | — | 🌎 NA |
| Empiric therapy | 15-30 mg/kg | IV/IM/SC | Not specified | — | 🌎 NA |
- Empiric therapy: Route not specified, assume IV, IM or SC
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Empiric therapy | 10-15 mg/kg | IV/IM/SC | Not specified | — | 🌎 NA |
| Susceptible infections | 15 mg/kg (route not specified) once daily (q24h). Neutropenic or immunocompromised patients may still need to be dosed q8h (dose divided). | Not specified | q24h (or q8h) | — | 🌎 NA |
| Sepsis | 20 mg/kg once daily IV | IV | q24h | — | 🌎 NA |
- Empiric therapy: Route not specified, assume IV, IM or SC
Pequeños mamíferos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Susceptible infections (Rabbits) | 8-16 mg/kg daily dose (may divide into q8h-q24h) SC, IM or IV. If given IV, dilute into 4 mL/kg of saline and give over 20 minutes. | SC/IM/IV | q8-24h | — | 🌎 NA |
| Susceptible infections (Rabbits) | 5-10 mg/kg SC, IM, IV divided q8-24h | SC/IM/IV | q8-24h | — | 🌎 NA |
| Susceptible infections (Guinea pigs) | 10-15 mg/kg SC, IM, IV divided q8-24h | SC/IM/IV | q8-24h | — | 🌎 NA |
| Susceptible infections (Chinchillas) | 10-15 mg/kg SC, IM, IV divided q8-24h | SC/IM/IV | q8-24h | — | 🌎 NA |
| Susceptible infections (Hamster, rats, mice) | 10 mg/kg SC, IM q12h | SC/IM | q12h | — | 🌎 NA |
| Susceptible infections (Prairie Dogs) | 5 mg/kg SC, IM q12h | SC/IM | q12h | — | 🌎 NA |
| Susceptible infections (Chinchillas) | 2-5 mg/kg SC, IM q8-12h | SC/IM | q8-12h | — | 🌎 NA |
| Susceptible infections (Fish) | 5 mg/kg IM loading dose, then 2.5 mg/kg every 72 hours for 5 treatments. | IM | q72h | 5 treatments | 🌎 NA |
- Susceptible infections (Rabbits): Increased efficacy and decreased toxicity if given once daily.
- Susceptible infections (Fish): Mapped to smallMammals array due to schema constraints.
Hurones
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Susceptible infections | 8-16 mg/kg IM or IV once daily | IM/IV | q24h | — | 🌎 NA |
| Susceptible infections | 8-16 mg/kg/day SC, IM, IV divided q8-24h | SC/IM/IV | q8-24h | — | 🌎 NA |
Aves
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Sunken eyes/sinusitis in macaws caused by susceptible bacteria | 40 mg/kg IM once or twice daily | IM | q12-24h | May require 2 weeks of treatment | 🌎 NA |
| Susceptible infections | 15 mg/kg IM or SC q12h | IM/SC | q12h | — | 🌎 NA |
| Gram-negative infections resistant to gentamicin | 15-20 mg/kg (0.015 mg/g) IM once a day or twice a day | IM | q12-24h | — | 🌎 NA |
| Susceptible infections (Ratites) | 7.6-11 mg/kg IM twice daily; air cell: 10-25 mg/egg; egg dip: 2000 mg/gallon of distilled water pH of 6 | IM/Topical | BID | — | 🌎 NA |
- Sunken eyes/sinusitis in macaws caused by susceptible bacteria: Must also flush sinuses with saline mixed with appropriate antibiotic (10-30 mL per nostril).
- Gram-negative infections resistant to gentamicin: Dilute commercial solution.
Reptiles
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Susceptible infections (Snakes) | 5 mg/kg IM (forebody) loading dose, then 2.5 mg/kg q72h for 7-9 treatments. | IM | q72h | 7-9 treatments | 🌎 NA |
| Susceptible infections (Gopher snakes) | 5 mg/kg IM loading dose, then 2.5 mg/kg q72h. | IM | q72h | — | 🌎 NA |
| Bacterial shell diseases in turtles | 10 mg/kg daily in water turtles, every other day in land turtles and tortoises for 7-10 days. | Not specified | q24h or q48h | 7-10 days | 🌎 NA |
| Susceptible infections (Crocodilians) | 2.25 mg/kg IM q 72-96h | IM | q72-96h | — | 🌎 NA |
| Gram-negative respiratory disease | 3.5 mg/kg IM, SC or via lung catheter every 3-10 days for 30 days. | IM/SC/Lung catheter | q3-10d | 30 days | 🌎 NA |
- Susceptible infections (Snakes): Commonly used in respiratory infections. Use a lower dose for Python curtus.
- Susceptible infections (Gopher snakes): House snakes at high end of their preferred optimum ambient temperature.
- Bacterial shell diseases in turtles: Used commonly with a beta-lactam antibiotic. Recommended to begin therapy with 20 mL/kg fluid injection. Maintain hydration and monitor uric acid levels.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Susceptible infections | 21 mg/kg IV or IM once daily (q24h) | IV/IM | q24h | — | 🌎 NA |
| Susceptible infections (Neonatal foals) | 21 mg/kg IV once daily | IV | q24h | — | 🌎 NA |
| Susceptible infections (Neonatal foals) | Initial dose of 25 mg/kg IV once daily | IV | q24h | — | 🌎 NA |
| Susceptible infections (Adults) | 10 mg/kg IM or IV once daily (q24h) | IM/IV | q24h | — | 🌎 NA |
| Susceptible infections (Foals <30 days old) | 20-25 mg/kg IV or IM once daily (q24h) | IV/IM | q24h | — | 🌎 NA |
| Septic joints | 20 mg/kg IV once daily | IV | q24h | — | 🌎 NA |
| Uterine infusion | 2 grams mixed with 200 mL sterile normal saline (0.9% sodium chloride for injection) and aseptically infused into uterus daily for 3 consecutive days | Intrauterine | q24h | 3 days | 🌎 NA |
| Uterine infusion | 1-2 grams intrauterine | Intrauterine | Not specified | — | 🌎 NA |
| Septic arthritis in foals (adjunctive) | If a single joint is involved, inject 250 mg daily or 500 mg every other day | Intra-articular | q24h or q48h | — | 🌎 NA |
| Regional intravenous limb perfusion (RILP) in standing horses | Usual dosages range from 500 mg-2 grams; dosage must be greater than 250 mg when a cephalic vein is used for perfusion | RILP | Not specified | — | 🌎 NA |
- Susceptible infections (Neonatal foals): Strongly recommend to individualize dosage based upon therapeutic drug monitoring.
- Septic joints: Usually used with a penicillin, at least until a definitive culture is obtained.
- Septic arthritis in foals (adjunctive): Frequency is dependent upon how often joint lavage is performed. Use cautiously in multiple joints as toxicity may result.
- Regional intravenous limb perfusion (RILP) in standing horses: Careful placement of tourniquets must be performed.
Ganado
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Susceptible infections | 10 mg/kg IM q8h or 25 mg/kg q12h | IM | q8h or q12h | — | 🌎 NA |
| Susceptible infections | 22 mg/kg/day IM divided three times daily | IM | TID | — | 🌎 NA |
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La amikacina es un antibiótico aminoglucósido semisintético potente derivado de la kanamicina. Se reserva principalmente para infecciones bacterianas gramnegativas aerobias graves y multirresistentes (MDR) (p. ej., Pseudomonas aeruginosa, E. coli, Klebsiella, Proteus). Debido a que resiste muchas de las enzimas que inactivan la gentamicina, a menudo es eficaz contra cepas resistentes a esta última.
Perla clínica: Los aminoglucósidos exhiben una actividad bactericida dependiente de la concentración y un efecto post-antibiótico (EPA) significativo. En consecuencia, los protocolos veterinarios modernos favorecen firmemente la administración una vez al día (dosis alta, intervalo extendido) para maximizar las concentraciones pico (mejorando la eliminación bacteriana) mientras se permite que los niveles valle disminuyan, lo que minimiza el riesgo de nefrotoxicidad. No es activa contra hongos, virus ni la mayoría de las bacterias anaerobias.
Mecanismo de acción
Amikacin actively transports across the bacterial cell membrane via an oxygen-dependent mechanism (which is why it is ineffective against anaerobic bacteria). Once inside, it binds irreversibly to the 30S ribosomal subunit.
Binding to 30S subunit → interferes with the initiation complex between mRNA and the ribosome → causes misreading of the genetic code → produces nonfunctional proteins → leads to rapid bacterial cell death.
Clinical Pearl: Its antimicrobial activity is significantly enhanced in an alkaline environment and markedly reduced in purulent, acidic, or necrotic debris.
Seguridad y advertencias
Contraindicaciones
- Hypersensitivity to aminoglycosides
- Generally contraindicated in rabbits/hares (adversely affects GI flora balance)
Efectos adversos
- Nephrotoxicity (tubular necrosis)
- Ototoxicity (auditory and vestibular)
- Neuromuscular blockade
- Facial edema
- Injection site pain/inflammation
- Peripheral neuropathy
- Hypersensitivity reactions
Precauciones
Use with extreme caution in patients with preexisting renal disease; requires concomitant monitoring and dosage interval adjustments. Other risk factors for toxicity include age (neonatal and geriatric), fever, sepsis, and dehydration.
- Ototoxicity: Can cause irreversible ototoxicity; use with caution in 'working' dogs (e.g., seeing-eye, herding, hearing-impaired assistance dogs).
- Neuromuscular Disorders: Use with caution in patients with conditions like myasthenia gravis due to neuromuscular blocking activity.
- Breed Considerations: Sighthound dogs (e.g., Greyhounds) have significantly smaller volumes of distribution and may require reduced dosages.
- Food Animals: Use in food-producing animals is controversial as drug residues may persist for long periods, particularly in renal tissue.
Interacciones farmacológicas
May have synergistic effects against some bacteria; potential for physical inactivation of aminoglycosides in vitro (do not mix together) and in vivo (patients in renal failure).
Potentially could cause additive nephrotoxicity (controversial, well documented only with older agents like cephaloridine and cephalothin).
Concurrent use may increase the nephrotoxic or ototoxic potential of the aminoglycosides.
May cause nephrotoxic effects; concurrent use with aminoglycosides should generally be avoided.
Potential for increased risk for nephrotoxicity.
Concomitant use could potentiate neuromuscular blockade.
Monitorización
- Efficacy (cultures, clinical signs, WBCs)
- Therapeutic drug monitoring (TDM) is highly recommended: Peak level should be at least 40 mcg/mL and the 4-hour trough sample less than 10 mcg/mL
- Renal function tests (BUN, creatinine) and urinalysis (USG, casts) pre-therapy and repeated during therapy
- Gross monitoring of vestibular or auditory toxicity
Farmacocinética
Vida media
Absorción
Not appreciably absorbed after oral or intrauterine administration, but is absorbed from topical administration during surgical irrigations. Bioavailability from extravascular injection (IM or SC) is >90%. Peak levels occur 0.5-1 hour after IM administration.
Distribución
Distributed primarily in the extracellular fluid. High levels found in sputum, bronchial secretions, and bile. Minimally protein bound (<20%). Does not readily cross the blood-brain barrier nor penetrate ocular tissue. Accumulates in inner ear and kidneys. Vd: 0.15-0.3 L/kg (adult cats/dogs), 0.26-0.58 L/kg (horses). Crosses the placenta.
Metabolismo
Aminoglycosides are generally not appreciably metabolized.
Eliminación
Elimination occurs almost entirely by glomerular filtration. Patients with decreased renal function can have significantly prolonged half-lives.
Sobredosis
Should an inadvertent overdosage be administered, three treatments have been recommended:
- Hemodialysis: Very effective in reducing serum levels but rarely a viable option for veterinary patients.
- Peritoneal dialysis: Will reduce serum levels but is much less efficacious.
- Complexation: Complexation of drug with either carbenicillin or ticarcillin (12-20 g/day in humans) is reportedly nearly as effective as hemodialysis.
Productos disponibles
Formulaciones
- Injection (50 mg/mL, 250 mg/mL)
- Intrauterine Solution (250 mg/mL)
Veterinario
- Amikacin Sulfate Injection: 50 mg/mL in 50 mL vials (Amiglyde-V, generic)
- Amikacin Sulfate Intrauterine Solution: 250 mg/mL in 48 mL vials (Amiglyde-V, generic)
Etiquetado para humanos
- Amikacin Injection: 50 mg/mL and 250 mg/mL in 2 mL & 4 mL vials and 2 mL syringes (Amikin, generic)
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store at room temperature (15-30°C); avoid freezing or temperatures above 40°C. Stable for at least 2 years at room temperature. Solutions may become very pale yellow with time, but this does not indicate a loss of potency.
Información para el cliente
La amikacina es un antibiótico potente utilizado para infecciones graves. Debido a que se administra mediante inyección, su veterinario le mostrará cómo administrarla si está tratando a su mascota en casa.
Importante: Este medicamento puede causar daño a los riñones y al oído interno (afectando la audición y el equilibrio).
- La hidratación es crucial: Asegúrese de que su mascota siempre tenga acceso a abundante agua fresca para ayudar a proteger sus riñones.
- Monitoree de cerca: Contacte a su veterinario de inmediato si nota cambios en la sed o la micción (beber/orinar más o menos de lo habitual), pérdida de equilibrio, inclinación de la cabeza o aparente pérdida de audición.
- No mezcle este medicamento con otros fármacos en la misma jeringa a menos que su veterinario le indique explícitamente lo contrario.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.