If a child has a serious infection, antibacterial drugs cannot be dispensed with. One of the very effective is Amikacin. Is it possible to treat children with such an antibiotic, how to dilute the medicine correctly and how can taking it harm the child's body?
Release form
Amikacin is produced in the form of a solution and in powder, but the medicine is packaged in ampoules and vials. Suspension, capsules or tablets of Amikacin do not exist, so this medicine cannot be drunk.
The powder form of Amikacin is presented in bottles with 250, 500 or 1000 mg of the active substance. They can be accompanied by ampoules with water for injection of 2 or 5 ml.
Ampoules with Amikacin solution are represented by a dosage of 250 mg of an antibiotic in 1 ml, and the ampoules themselves contain 2 or 4 ml of liquid. Also, the drug can be purchased in ampoules with a capacity of 2 ml, where the active substance contains 100 mg or 500 mg.
Composition
Only the active substance is present in the powder vials. The injection solution contains not only amikacin, but also sodium citrate, water, sulfuric acid and sodium disulfite.
Operating principle
Amikacin is a medicine that is classified as an antibiotic aminoglycoside. It is also an effective anti-tuberculosis drug. After entering the body, this antibacterial drug penetrates through the cell membranes of pathogens, and then binds to the intracellular components of bacteria and disrupts protein synthesis in microbial cells. As a result, bacteria die, so the action of Amikacin is called bactericidal.
The spectrum of activity of Amikacin against microorganisms is quite wide.
This medicine is effective against:
- Pseudomonas.
- Escherichia coli.
- Klebsiella.
- Enterobacter.
- Shigella.
- Streptococci.
- Salmonella.
- Staphylococci.
- Serratia.
- Providences.
- Mycobacteria.
Amikacin often helps with resistance to other antibacterial agents, such as penicillin, gentamicin, or isoniazid. Resistance to such a drug is rare (more than 70% of microbes remain sensitive to it).
The drug is almost not absorbed and is rapidly destroyed in the digestive tract, so it is administered by injection. The maximum concentration of Amikacin is reached in the patient's body after 30-60 minutes, then it decreases to therapeutic and acts for about 10-12 hours. Amikacin easily penetrates tissues and can act in bones, brain, lungs, heart muscle and other organs.
Indications
The reason for prescribing Amikacin can be various infectious diseases.
This medicine is prescribed:
- With pneumonia, bronchitis, abscesses in the lungs or bacterial lesions of the pleura.
- With endocarditis (subacute and acute forms).
- With tuberculosis.
- With gonococcal infection.
- With purulent otitis media.
- With bacterial meningitis and other infections of the central nervous system.
- With intestinal infections.
- With peritonitis and other microbial lesions of the abdominal organs.
- With cholangitis.
- With infectious lesions of the subcutaneous tissue and skin.
- With bacteria-provoked myositis, bursitis or arthritis.
- With osteomyelitis.
- With infectious inflammation of the urinary tract.
- With chemical or thermal burns.
- For eye diseases (the medicine is applied topically).
- For postoperative infections.
- With sepsis.
From what age is it allowed to take?
Instructions for use for children allow the possibility of injecting Amikacin from birth, however for newborn babies, this medicine is administered very carefully. The appointment of the drug to a premature baby also requires special attention.
For children of any age, only a doctor should prescribe Amikacin, because the use of this drug has its own precautions. In addition, the doctor will be able to accurately calculate the required dose, since babies at 3 years old require a completely different amount of medicine than children at 8 years old or older.
Contraindications
The appointment of Amikacin is contraindicated in case of intolerance to this drug, as well as hypersensitivity to other antibiotics from the aminoglycoside group.
Also, this medicine is not given:
- For problems with hearing or vestibular apparatus.
- With neuritis of the auditory nerve.
- If kidney function is impaired, for example, tests show azotemia, uremia, or renal failure.
- For severe cardiac pathologies.
- For serious diseases of the hematopoietic organs.
The drug is used very carefully if the patient is dehydrated. For pregnant women, such a medicine is prescribed only if there are vital indications, because Amikacin penetrates the placenta and can negatively affect the hearing and kidneys of the fetus. The medication also passes into human milk, therefore, Amikacin treatment is not combined with breastfeeding.
Side effects
Amikacin has a negative effect on the 8 pair of cranial nerves, especially if the patient has dehydration or renal impairment. Therefore, taking such a medication often provokes a feeling of stuffiness in the ears, noises, hearing loss, and a high dosage can lead to irreversible deafness.
This antibiotic also has a nephrotoxic effect. Taking it can lead to hematuria, oliguria, excretion of protein in the urine, and renal failure. In addition, the drug negatively affects the sense of balance. The patient after treatment with Amikacin may feel dizziness and lose coordination of their movements.
Other side effects during therapy with Amikacin are:
- Headaches.
- Shaking hands.
- Twitching of muscles.
- Paresthesias.
- Lowering blood pressure.
- Palpitations.
- Anemia.
- Nausea.
- Dysbacteriosis.
- Diarrhea.
- Itchy skin, hives and other allergic reactions.
- Vomiting.
- Pain at the injection site.
- Inflammation of the skin.
- Fever.
- Inflammation of the vein with intravenous injection.
Instructions for use and dosage
- Before treatment with Amikacin, it is recommended to make an analysis for the sensitivity of the pathogen to such a drug.
- Amikacin can be administered to a child intramuscularly or intravenously. The medicine is injected into a vein either slowly in a stream (about two minutes) or by drip (about 60 drops per minute).
- An injection solution from Amikacin powder should be prepared immediately before injection. In a bottle with 0.25 or 0.5 g of the drug for intramuscular injection add 2 or 3 ml of special water for injection. To make an intravenous infusion, the contents of the vial are diluted in 200 ml of glucose or saline so that a solution with a concentration of less than 5 mg / ml is obtained.
- It is not recommended to combine Amikacin solution with any other drugs in the same infusion system or in the same syringe, so as not to provoke the appearance of inactive complexes.
- During therapy with Amikacin, kidney function should be monitored (the level of urea and creatinine in blood tests is determined) and the state of the vestibular cochlear nerves (audiogram is made).
- The dose of Amikacin should be calculated based on the weight of the child. Treatment begins with a single dose of 10 mg per kg of body weight and then increases to 15 mg / kg per day. Such a daily dose is divided into 2 or 3 doses, that is, the child is administered 7.5 mg / kg of the drug every 12 hours or 5 mg / kg every 8 hours. For example, if a child weighs 22 kg, then for the first injection he needs 220 mg of the drug, and then the drug should be administered twice a day at 165 mg or three times a day at 110 mg.
- The course of treatment with Amikacin lasts from 3 to 7 days if the drug is injected into a vein, and 7-10 days if intramuscular administration is used. If treatment within 5 days does not work, the antibiotic is replaced.
Overdose
Exceeding the dose of Amikacin can cause a toxic reaction in the patient. The medicine causes a neuromuscular blockage that can stop breathing. If the drug is administered in too high a dosage to a baby, it leads to depression of the nervous system. The child becomes lethargic, may fall into a coma and stop breathing.
To treat an overdose, the patient is injected with atropine, calcium chloride, anticholinesterase drugs and other symptomatic drugs. If the condition is very poor, blood transfusion and mechanical ventilation are indicated.
Interaction with other drugs
- Amikacin has been noted to be incompatible with many other drugs. Among the drugs that should not be prescribed together with such an antibiotic are heparin, penicillins, erythromycin, B vitamins, potassium chloride, cephalosporins, ascorbic acid and some other drugs.
- If Amikacin is used together with other aminoglycosides or after a course of any of the antibiotics of this group, the antimicrobial effect of the drug will be less pronounced, and the toxic effect will increase.
- The nephrotoxic effect of Amikacin may be enhanced by the simultaneous administration of this drug and vancomycin, amphotericin B, polymyxin, nalidixic acid or cephalothin.
- When Amikacin is given in conjunction with a loop diuretic such as furosemide, it will increase the antibiotic's negative effects on hearing.
- If injections of Amikacin are combined with magnesium sulfate, narcotic analgesics, inhalation anesthesia, polymyxins or curariform drugs, this will lead to an increase in neuromuscular blockade.
Terms of sale
The purchase of the drug is available only with a prescription.
Storage conditions and shelf life
The place where ampoules or vials of Amikacin will be stored must be protected from light and out of reach of children. The storage temperature should not exceed +25 degrees. The shelf life of the medicine is 3 years.
Reviews
Most reviews on the use of Amikacin in children are positive. Parents note that the medicine is very effective and quickly helps a sick child (after the first injection). In pediatrics, this medication is most often prescribed for intestinal infections.
The main the minus of intramuscular injections of Amikacin is called their rather pronounced pain, therefore, many doctors, instead of water for injection, are allowed to dilute the drug with novocaine. This helps to reduce discomfort from the injections.
Analogs
Instead of Amikacin, you can use other drugs with the same active substance, for example, Hemomycin, Farcycline or Amikin. Instead of Amikacin, other aminoglycosides can also be used, for example Netilmicin or Tobramycin. Moreover, if it is required to replace Amikacin with another antibacterial agent, for this it is worth finding out the sensitivity of bacteria to other antibiotics.
