Kacin 500 mg/2 ml Injection

Aminoglycoside antibiotic injection (hospital) for serious Gram-negative infections, especially resistant to gentamicin:

• Septicaemia, neonatal sepsis
• Hospital-acquired pneumonia, complicated urinary tract infections, intra-abdominal, bone and joint infections
• Febrile neutropenia (with a beta-lactam)
• Multidrug-resistant tuberculosis and non-tuberculous mycobacteria (specialist)

Given by health professionals with blood level monitoring.

• Adults and children: 15 mg/kg once daily IV/IM (or 7.5 mg/kg every 12 hours); maximum about 1.5 g/day; usually 7–10 days.
• Neonates: loading 10 mg/kg then 7.5 mg/kg every 12–24 hours depending on age.
• Kidney impairment: dose interval extended according to levels/creatinine clearance.
• Elderly and obese: dose by adjusted body weight.

• Allergy to amikacin or other aminoglycosides
• Myasthenia gravis

Serious (dose- and duration-related): hearing loss, tinnitus, balance problems (may be permanent), kidney damage (usually reversible), neuromuscular blockade/breathing weakness.

Less common: rash, fever, nausea, low magnesium, injection-site pain.

• Monitor blood levels, kidney function and hearing; avoid prolonged courses.
• Elderly, dehydration, pre-existing kidney or hearing problems: higher risk.
• Mitochondrial gene variants (m.1555A>G) increase deafness risk.

Avoid in pregnancy unless life-threatening infection (can cause deafness in the baby). Compatible with breastfeeding (poor oral absorption by infant).

• Loop diuretics (furosemide) — ear damage
• Vancomycin, amphotericin B, ciclosporin, cisplatin, colistin, NSAIDs, contrast — kidney damage
• Neuromuscular blockers, anaesthetics — respiratory paralysis
• Penicillins mixed in the same infusion (inactivation)

Kidney and ear toxicity, respiratory paralysis. Haemodialysis removes amikacin.

Store below 30°C. Do not freeze.