藥劑部參考美國 Johns Hopkins 大學研究團隊所建立的 NxP (Nephrotoxic Potential) 專家共識分級清單，本品具「顯著以上腎毒性風險」，被認定具中度至高度腎損傷潛勢，特別是同時合併其他腎毒性藥物、脫水、高齡或既有腎功能異常的患者族群，應更加注意。

【缺藥訊息】 公告日期：2023/11/3。 缺藥品項：Acemycin 針 500mg/2mL/Vial。 缺藥原因：因製造問題缺貨。 替代藥品：國內有同成份不同規格替代品。 配套措施：採購替代品，庫存量用罄關檔停用，替代品預計於11/17到貨 (依照實際到貨日為準)。

Aminoglycoside類抗生素

Serious infections (eg, bloodstream infection, bone infections, respiratory tract infections, endocarditis, and septicemia):
due to gram-negative organisms, including Pseudomonas, Escherichia coli, Proteus, Providencia, Klebsiella, Enterobacter, Serratia, and Acinetobacter

Aminoglycoside antibiotic:
Inhibits protein synthesis in susceptible bacteria by binding to 30S ribosomal subunits

Distribution:
1. Vd: 0.25 L/kg; primarily into extracellular fluid (highly hydrophilic)
2. Penetrates blood-brain barrier when meninges inflamed.
Elimination Half-life: renal function and age dependent
1. Infants, low birth weight (1-3 days): 7-9 hrs
2. Infants, full-term >7 days: 4-5 hrs
3. Children: 1.6-2.5 hrs
4. Adults: Normal renal function: 1.4-2.3 hrs; Anuria/end-stage renal disease: 28-86 hrs
Excretion: Urine (94% to 98%). Dialyzable( HD and PD).

1. Hypersensitivity to amikacin or other amino-glycosides antibiotics.
2. Patient with impaired renal function.

D

Infant risk cannot be ruled out.

Ototoxicity, nephrotoxicity, neurotoxicity

Adults: 15-20 mg/kg/day IM or IV, in divided doses Q8H or Q12H, maximum dose 1.5 g/day

Infants and Children: 5-7.5 mg/kg/dose every 8 hours

Dosage adjustment: Loading dose 7.5 mg/kg, then according to ClCr (ml/min) to calculate maintenance dosage:
1. ClCr ≧60 mL/min: Administer Q8H
2. ClCr 40-60 mL/min: Administer Q12H
3. ClCr 20-40 mL/min: Administer Q24H
4. ClCr <20 mL/min: Loading dose, then monitor levels
5. Intermittent hemodialysis (administer after hemodialysis): 5-7.5 mg/kg Q48-72H
6. CVVH/CVVHD/CVVHDF: Loading dose of 10 mg/kg followed by maintenance dose of 7.5 mg/kg Q24-48H.

The original solution may discoloration during oxidation, this color change does not affect potency.