Drug Therapy for Infectious Diseases of the Dog and Cat

Valerie J. Wiebe

• Editorial: Wiley-Blackwell
• Año: 2015
• ISBN:
  9781118557457
• Edición: 1
• Categoría: Medicine
• Categoría: Veterinary Medicine

Drug Therapy for Infectious Diseases of the Dog and Cat provides fast access to all the information needed to effectively and responsibly treat infectious disease in dogs and cats, with easy searching by either drug or organism.

• Provides fast access to essential information on prescribing antibiotics, antifungals, antiparasitics, and antivirals
• Offers alphabetical searching by either drug or organism
• Focuses on clinically relevant information
• Covers information on each drug using a common format for ease of use
• Presents a reliable quick reference to the correct use of antibiotics in veterinary practice

SECTION D
Antibiotics

Chapter 126: Amikacin

---

US Generic (Brand) Name: Amikacin (Amikin, Amiglyde-V, Amiject D, Amikacin C, Caniglide)

Availability: Human approved – Amikacin sulfate sterile injectable (50 mg/mL, 250 mg/mL × 2 mL, vials or 2 mL syringes). Veterinary approved – Amikacin sulfate sterile injectable (50 mg/mL × 50 mL bottles)

Resistance mechanisms: Aminoglycoside modifying enzymes, ribosome alteration, decreased permeability

---

Use

Serious gram negative infections due to Pseudomonas, Proteus, Serratia, or gram positive bacilli involving the respiratory tract, urinary tract, septicemia, endocarditis, or bone infections that are resistant to gentamycin and tobramycin. May be useful in severe bacterial endophthalmitis. Poor efficacy against intracellular bacilli✔ anaerobes, and mycoplasma. Only effective against some strains of Mycobacteria (M. avium), Actinomyces, Nocardia spp., Corynebacterium, and Bacillus spp.

Contraindications/warnings

Use with caution in animals with renal impairment, monitor the animal closely for signs of tubular necrosis (casts appear early in urine). Avoid use in animals with pre-existing vestibular impairment, electrolyte imbalances, and/or myasthenia gravis. Discontinue drug if signs of hypersensitivity, ototoxicity, or nephrotoxicity. Avoid use with other renal toxic drugs or prolonged therapy.

Dosage

Dosing should be individualized due to the low therapeutic index. Base the dose on ideal body weight in obese animals. Animals with endotoxemia may have increased risk of renal toxicity.

Canine

15–30 mg/kg IV, IM, SC q24 h. Dose reduce in greyhounds and sight hounds to 10–12 mg/kg IV, IM, SC q24 h. Use higher doses for sepsis (Papich 2002, Kukanich and Coetzee 2008).

Feline

10–14 mg/kg IV, IM, SC q24 h. SC dosing is preferred because of rapid absorption, good bioavailability and ease of administration (Jernigan et al., 1988, Papich 2002).

Dose adjustments

Dose adjust in renal failure. Give a loading dose, then give 50% of the dose with moderate renal failure and 25% of the dose in severe renal failure. Monitor serum levels and adjust doses accordingly. No dose adjustment for hepatic insufficiency.

Administration

Hydrate animals prior to administration. SC or IV fluids are recommended to prevent renal toxicity. For IM or SC dosing, the dose should be drawn up from the 50 or 250 mg/mL vial and injected directly, either SC or in a large muscle. For IV administration the dose should be drawn up and diluted with 100–200 mL of a compatible solution (0.9% saline, 5% dextrose in water, lactated ringers, normasol, plasma-lyte 56 or 148, etc.). The infusion rate should be sufficient to provide the dose over 1–2 h in small animals or 0.5–1 h in larger animals.

Electrolyte contents

Sodium concentration in one gram is 29.9 mg (1.3 mEq).

Storage/stability

May change to a light straw color, but not indicative of a loss in potency. Final concentrations between 0.25–5 mg/mL in most IV fluids are stable for 24 h at room temperature or 2 days under refrigeration when mixed with 5% dextrose in water, 0.9% saline, or lactated ringers. Dilute solutions (0.25 and 5 mg/mL) can be frozen at −15°C for 30 days if used within 24 h when brought to room temperature.

Adverse reactions

>10%

Renal toxicity is common at high doses (30 mg/kg/day) (gentamicin > amikacin > tobramycin). Nephrotoxicity is polyuric with increased fractional electrolyte excretion, glycosuria, and tubular casts, may progress to oliguria. Acute tubular necrosis manifested by increases in serum creatinine and BUN have been reported in dogs and cats. Renal damage is typically reversible if good urine output is maintained. Diarrhea, vomiting and injection site reactions (SC, IM doses) are reported commonly in dogs and cats.

1–10%

Ototoxicity may be irreversible. Neurotoxicity to the eighth cranial nerve (cochlear toxicity > vestibular toxicity with amikacin in dogs), vestibular injury and bilateral irreversible damage is related to the amount of drug given ...