硫酸アミカシン
Amikacin Sulfate
Amikacin sulfate
別名: Amikin · Amiglyde-V · amikacin sulphate · amikacini sulfas · BB-K8
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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
小型哺乳類
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
フェレット
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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 |
鳥
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
爬虫類
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
馬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
牛
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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 |
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
アミカシンは、カナマイシンから誘導された強力な半合成アミノグリコシド系抗生物質です。主に重篤な多剤耐性（MDR）のグラム陰性好気性菌感染症（緑膿菌、大腸菌、クレブシエラ、プロテウスなど）に用いられます。ゲンタマイシンを不活化する多くの酵素に対して耐性を持つため、ゲンタマイシン耐性菌にも有効な場合が多いです。
臨床のポイント: アミノグリコシド系は濃度依存性の殺菌作用と有意なポストアンチビオティックエフェクト（PAE）を示します。そのため、現代の獣医療では、ピーク濃度を最大化して殺菌効果を高めつつ、トラフ濃度を下げることで腎毒性のリスクを最小限に抑える1日1回（高用量・投与間隔延長）投与が強く推奨されています。真菌、ウイルス、およびほとんどの嫌気性菌には無効です。
作用機序
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.
安全性・警告
禁忌
- Hypersensitivity to aminoglycosides
- Generally contraindicated in rabbits/hares (adversely affects GI flora balance)
有害事象
- Nephrotoxicity (tubular necrosis)
- Ototoxicity (auditory and vestibular)
- Neuromuscular blockade
- Facial edema
- Injection site pain/inflammation
- Peripheral neuropathy
- Hypersensitivity reactions
注意事項
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.
医薬品相互作用
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.
監視
- 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
薬物動態
半減期
吸収
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.
分布
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.
代謝
Aminoglycosides are generally not appreciably metabolized.
消失
Elimination occurs almost entirely by glomerular filtration. Patients with decreased renal function can have significantly prolonged half-lives.
過剰投与
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.
製品
製剤
- Injection (50 mg/mL, 250 mg/mL)
- Intrauterine Solution (250 mg/mL)
動物用医薬品
- 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)
ヒト用医薬品
- Amikacin Injection: 50 mg/mL and 250 mg/mL in 2 mL & 4 mL vials and 2 mL syringes (Amikin, generic)
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
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.
飼主向け情報
アミカシンは重篤な感染症に使用される強力な抗生物質です。注射で投与されるため、自宅で治療を行う場合は獣医師が投与方法を指導します。
重要: この薬は腎臓や内耳（聴覚や平衡感覚）に損傷を与える可能性があります。
- 水分補給が重要です: 腎臓を保護するため、ペットが常に新鮮な水を十分に飲めるようにしてください。
- 注意深く観察してください: 飲水量や尿量の変化（通常より多い、または少ない）、ふらつき、首の傾き、または耳が聞こえにくそうな様子に気づいた場合は、すぐに獣医師に連絡してください。
- 獣医師の明確な指示がない限り、この薬を他の薬と同じ注射器で混ぜないでください。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。