황산 아미카신
Amikacin Sulfate
Amikacin sulfate
다른 이름: Amikin · Amiglyde-V · amikacin sulphate · amikacini sulfas · BB-K8
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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
소형 포유류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
페렛
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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 |
새
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
파충류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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 |
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
아미카신은 카나마이신에서 유래한 강력한 반합성 아미노글리코사이드계 항생제입니다. 주로 심각한 다제내성(MDR) 그람 음성 호기성 세균 감염(예: 녹농균, 대장균, 클레브시엘라, 프로테우스)에 사용됩니다. 겐타마이신을 불활성화하는 많은 효소에 저항성이 있어 겐타마이신 내성 균주에도 효과적인 경우가 많습니다.
임상 요점: 아미노글리코사이드계는 농도 의존적 살균 활성과 유의미한 항생제 후 효과(PAE)를 나타냅니다. 따라서 현대 수의학에서는 최고 농도를 극대화하여 살균력을 높이고 최저 농도를 낮춰 신독성 위험을 최소화하는 1일 1회(고용량, 연장 간격) 투여를 강력히 권장합니다. 진균, 바이러스 및 대부분의 혐기성 세균에는 효과가 없습니다.
작용 기전
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.
안전성·주의사항
금기사항
- Hypersensitivity to aminoglycosides
- Generally contraindicated in rabbits/hares (adversely affects GI flora balance)
부작용
- Nephrotoxicity (tubular necrosis)
- Ototoxicity (auditory and vestibular)
- Neuromuscular blockade
- Facial edema
- Injection site pain/inflammation
- Peripheral neuropathy
- Hypersensitivity reactions
주의
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.
약물 상호작용
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.
모니터링
- 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
약동학
반감기
흡수
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.
분포
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.
대사
Aminoglycosides are generally not appreciably metabolized.
배설
Elimination occurs almost entirely by glomerular filtration. Patients with decreased renal function can have significantly prolonged half-lives.
과다투여
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.
제품
제형
- Injection (50 mg/mL, 250 mg/mL)
- Intrauterine Solution (250 mg/mL)
동물용의약품
- 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)
인용의약품
- Amikacin Injection: 50 mg/mL and 250 mg/mL in 2 mL & 4 mL vials and 2 mL syringes (Amikin, generic)
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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.
보호자 정보
아미카신은 심각한 감염에 사용되는 강력한 항생제입니다. 주사로 투여되므로 집에서 반려동물을 치료하는 경우 수의사가 투여 방법을 알려줄 것입니다.
중요: 이 약물은 신장과 내이(청력 및 균형 감각에 영향을 미침)에 손상을 줄 수 있습니다.
- 수분 공급이 중요합니다: 신장을 보호하기 위해 반려동물이 항상 신선한 물을 충분히 마실 수 있도록 해주세요.
- 주의 깊게 관찰하세요: 갈증이나 배뇨의 변화(평소보다 물을 많이/적게 마시거나 소변을 많이/적게 봄), 균형 상실, 고개 기울임 또는 청력 상실의 징후를 발견하면 즉시 수의사에게 연락하세요.
- 수의사의 명확한 지시가 없는 한 이 약물을 같은 주사기에서 다른 약물과 섞지 마세요.
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