阿米卡星硫酸鹽
Amikacin Sulfate
Amikacin sulfate
別名: Amikin · Amiglyde-V · amikacin sulphate · amikacini sulfas · BB-K8
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
雪貂
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
爬蟲類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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 |
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
阿米卡星是一種強效的半合成氨基醣苷類抗生素，衍生自卡那黴素。主要用於治療嚴重的多重耐藥 (MDR) 革蘭氏陰性需氧菌感染（如綠膿桿菌、大腸桿菌、克雷伯氏菌、變形桿菌）。由於它能抵抗許多使慶大黴素失活的酶，因此對慶大黴素耐藥菌株通常有效。
臨床要點： 氨基醣苷類具有濃度依賴性殺菌活性和顯著的抗生素後效應 (PAE)。因此，現代獸醫學強烈建議每日一次（高劑量、延長間隔）給藥，以最大化峰值濃度（提高殺菌效力），同時讓谷值濃度下降，從而降低腎毒性風險。它對真菌、病毒和大多數厭氧菌無效。
作用機制
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.
安全性與警告
禁忌症
- Hypersensitivity to aminoglycosides
- Generally contraindicated in rabbits/hares (adversely affects GI flora balance)
不良反應
- 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.
藥物相互作用
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.
監測
- 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
藥物動力學
半衰期
吸收
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.
分佈
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.
排除
Elimination occurs almost entirely by glomerular filtration. Patients with decreased renal function can have significantly prolonged half-lives.
過量
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.
可用產品
劑型
- Injection (50 mg/mL, 250 mg/mL)
- Intrauterine Solution (250 mg/mL)
獸醫用
- 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)
人用標示
- Amikacin Injection: 50 mg/mL and 250 mg/mL in 2 mL & 4 mL vials and 2 mL syringes (Amikin, generic)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
阿米卡星是一種用於治療嚴重感染的強效抗生素。因為它是注射給藥，如果您在家中為寵物治療，獸醫會指導您如何操作。
重要提示： 該藥物可能對腎臟和內耳（影響聽力和平衡）造成損害。
- 保持水分至關重要： 確保您的寵物隨時有充足的新鮮飲水，以幫助保護牠們的腎臟。
- 密切觀察： 如果您發現寵物的飲水或排尿習慣改變（喝多/尿多或減少）、失去平衡、頭部傾斜或明顯聽力下降，請立即聯繫獸醫。
- 除非獸醫明確指示，否則請勿將此藥物與其他藥物混合在同一注射器中。
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