Therapeutic Uses

Amikacin is preferred for the initial treatment of serious nosocomial gram-negative bacillary infections in hospitals where gentamicin and tobramycin resistance is prevalent. Amikacin is active against the vast majority of aerobic gram-negative bacilli, including most strains of Serra-tia, Proteus, and P. aeruginosa. It is active against nearly all strains of Klebsiella, Enterobacter, and E. coli that are resistant to gentamicin and tobramycin. Most resistance to amikacin is found among strains of Acinetobacter, Providencia, and Flavobacter and strains of Pseudomonas other than P. aeruginosa; these all are unusual pathogens. Amikacin is less active than gentamicin against enterococci and should not be used. Amikacin is not active against the majority of grampositive anaerobic bacteria. It is active against M. tuberculosis, including streptomycin-resistant strains, and atypical mycobacteria. It has been used in the treatment of disseminated atypical mycobacterial infection in acquired immunodeficiency syndrome (AIDS) patients.

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