Amikacin Macure
Aminoglycoside antibiotic – Solution for injection/infusion 250 mg/ml
Quick facts about Amikacin Macure
Key takeaways about Amikacin Macure
- Hospital-only antibiotic: Amikacin Macure is given by injection or infusion in a hospital setting, not taken at home by mouth
- Reserved for resistant infections: Typically used when bacteria are resistant to gentamicin and other first-line antibiotics
- Requires monitoring: Blood levels, kidney function, and hearing must be monitored during treatment to prevent toxicity
- Risk of kidney and hearing damage: Nephrotoxicity and ototoxicity are the most serious risks, especially with prolonged use or high doses
- Short treatment courses preferred: Treatment is typically limited to 7–10 days to minimize the risk of adverse effects
What Is Amikacin Macure and What Is It Used For?
Amikacin Macure is a semisynthetic aminoglycoside antibiotic containing the active substance amikacin (as amikacin sulfate). It is used to treat serious bacterial infections caused by susceptible gram-negative organisms, particularly when other aminoglycosides such as gentamicin or tobramycin are ineffective due to bacterial resistance.
Amikacin belongs to the aminoglycoside class of antibiotics, a group of bactericidal agents that have been a cornerstone in the treatment of serious gram-negative infections since the 1970s. Amikacin was specifically developed to resist many of the bacterial enzymes that inactivate other aminoglycosides, making it effective against a broader range of resistant organisms. It works by binding irreversibly to the bacterial 30S ribosomal subunit, disrupting protein synthesis and ultimately causing bacterial cell death.
The spectrum of activity of amikacin includes many clinically important gram-negative bacteria, including Pseudomonas aeruginosa, Escherichia coli, Klebsiella species, Enterobacter species, Serratia marcescens, Acinetobacter species, and Proteus species. It also has activity against some gram-positive organisms, particularly Staphylococcus aureus, although it is not typically used as monotherapy for gram-positive infections.
Amikacin Macure is indicated for the treatment of the following serious infections when caused by susceptible organisms:
- Septicemia (bloodstream infections): Including bacteraemia caused by gram-negative bacilli
- Serious respiratory tract infections: Including hospital-acquired pneumonia and ventilator-associated pneumonia
- Complicated urinary tract infections: Particularly pyelonephritis and urosepsis
- Bone and joint infections: Including osteomyelitis and septic arthritis
- Intra-abdominal infections: Including peritonitis, typically in combination with other antibiotics
- Skin and soft tissue infections: Including burn wound infections and surgical site infections
- Central nervous system infections: Including meningitis and ventriculitis (administered intrathecally or intraventricularly in some cases)
- Endocarditis: As part of combination therapy, particularly for prosthetic valve endocarditis
In clinical practice, amikacin is frequently used in combination with beta-lactam antibiotics (such as piperacillin-tazobactam or carbapenems) to achieve synergistic bactericidal activity. This combination approach is particularly valuable in critically ill patients with sepsis, febrile neutropenia, and infections caused by multidrug-resistant organisms. The World Health Organization (WHO) classifies amikacin as a "Watch" antibiotic under its AWaRe (Access, Watch, Reserve) classification, meaning it should be used judiciously and preferably based on culture and sensitivity results.
Aminoglycosides, including amikacin, are very poorly absorbed from the gastrointestinal tract when taken by mouth. This means oral administration would not achieve adequate blood levels to treat systemic infections. Therefore, amikacin must be administered parenterally – either as an intravenous infusion or intramuscular injection – to ensure therapeutic concentrations are reached in the bloodstream and at the site of infection.
What Should You Know Before Taking Amikacin Macure?
Before receiving Amikacin Macure, your healthcare provider must assess your kidney function, hearing, and other risk factors. This antibiotic carries significant risks of nephrotoxicity and ototoxicity, and several conditions and medications can increase these risks substantially.
Contraindications
Amikacin Macure must not be used in the following situations:
- Known hypersensitivity: Patients with a documented allergy to amikacin, other aminoglycosides (gentamicin, tobramycin, netilmicin, streptomycin), or any of the excipients in the formulation
- Myasthenia gravis: Aminoglycosides can worsen neuromuscular transmission and may precipitate a myasthenic crisis, potentially leading to respiratory failure
While not absolute contraindications, extreme caution is required in patients with pre-existing renal impairment, vestibular or cochlear impairment, or conditions affecting neuromuscular transmission such as botulism or Parkinson's disease.
Warnings and Precautions
Several important warnings and precautions must be considered before and during treatment with amikacin:
Nephrotoxicity (kidney damage): Amikacin can cause damage to the renal tubules, leading to acute kidney injury. The risk is increased with higher doses, prolonged treatment duration (beyond 10 days), pre-existing kidney disease, concurrent use of other nephrotoxic drugs, and dehydration. Kidney function should be monitored before treatment begins and at regular intervals during therapy, typically by measuring serum creatinine and estimated glomerular filtration rate (eGFR). Signs of nephrotoxicity include decreased urine output, rising creatinine levels, and electrolyte disturbances. Kidney damage caused by aminoglycosides is usually reversible if detected early and the drug is discontinued promptly.
Ototoxicity (hearing and balance damage): Amikacin can damage both the cochlear (hearing) and vestibular (balance) systems of the inner ear. Cochlear toxicity manifests as tinnitus (ringing in the ears) and high-frequency hearing loss, which may progress to clinically significant hearing impairment. Vestibular toxicity presents as dizziness, vertigo, ataxia (unsteady gait), and nystagmus. Unlike nephrotoxicity, ototoxicity may be irreversible even after the drug is stopped. The risk increases with higher cumulative doses, longer treatment courses, pre-existing hearing loss, concurrent use of other ototoxic drugs (especially loop diuretics), and renal impairment (which leads to drug accumulation).
Neuromuscular blockade: Aminoglycosides can cause neuromuscular blockade, particularly in patients receiving neuromuscular blocking agents, those with conditions such as myasthenia gravis, or during massive blood transfusions with citrated blood. This effect can lead to respiratory paralysis and requires immediate treatment with calcium gluconate and artificial ventilation.
Therapeutic drug monitoring (TDM): Due to the narrow therapeutic index of amikacin, regular measurement of blood drug levels is essential. Peak serum concentrations (measured 30 minutes after the end of a 30-minute IV infusion) should typically be between 20 and 35 mg/L for conventional dosing, while trough concentrations (measured just before the next dose) should be below 5–10 mg/L. For extended-interval (once-daily) dosing, different target ranges apply and nomograms are used for dose adjustment.
The risk of kidney damage and hearing loss is significantly increased when amikacin is used concurrently with other nephrotoxic or ototoxic drugs such as vancomycin, amphotericin B, cisplatin, ciclosporin, tacrolimus, loop diuretics (furosemide, bumetanide), or NSAIDs. If concurrent use is unavoidable, more frequent monitoring of kidney function and drug levels is mandatory.
Pregnancy and Breastfeeding
Pregnancy: Amikacin crosses the placental barrier and can cause irreversible bilateral sensorineural deafness in the developing fetus by damaging the eighth cranial nerve. Several cases of congenital deafness have been reported with other aminoglycosides (particularly streptomycin and kanamycin). Amikacin should only be used during pregnancy if the infection is life-threatening and no safer alternative antibiotic is available. If use is unavoidable, the patient must be fully informed of the potential risk to the fetus, and the lowest effective dose should be used for the shortest possible duration.
Breastfeeding: Amikacin is excreted in breast milk in small amounts. While systemic absorption by the infant is expected to be minimal due to poor oral bioavailability of aminoglycosides, there is a theoretical risk of effects on the infant's gut flora. Breastfeeding should be interrupted during treatment with amikacin, or a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Fertility: There are limited data on the effects of amikacin on human fertility. Animal studies have not shown adverse effects on fertility at therapeutic doses, but caution is advisable, as aminoglycosides may concentrate in renal cortical tissue and could theoretically affect reproductive function.
How Does Amikacin Macure Interact with Other Drugs?
Amikacin has clinically significant interactions with several drug classes. The most dangerous interactions involve other nephrotoxic or ototoxic agents, which can dramatically increase the risk of kidney damage and hearing loss. Neuromuscular blocking agents can potentiate the neuromuscular blocking effect of amikacin.
Drug interactions with amikacin are a critical consideration in hospital pharmacotherapy. Because amikacin is primarily used in critically ill patients who are often receiving multiple medications, the potential for harmful interactions is high. Understanding these interactions is essential for safe prescribing and monitoring.
Major Interactions
| Drug / Drug Class | Interaction Type | Clinical Effect | Management |
|---|---|---|---|
| Vancomycin | Additive nephrotoxicity and ototoxicity | Significantly increased risk of acute kidney injury and hearing loss | Monitor renal function daily; monitor drug levels of both agents; avoid prolonged concurrent use |
| Loop diuretics (furosemide, bumetanide) | Additive ototoxicity; altered amikacin clearance | Increased risk of irreversible hearing loss; potential for altered drug levels | Avoid concurrent use if possible; if unavoidable, perform audiometry and monitor drug levels closely |
| Cisplatin | Additive nephrotoxicity and ototoxicity | Severely increased risk of permanent hearing loss and renal failure | Avoid combination; if essential, delay amikacin until renal function has recovered |
| Amphotericin B | Additive nephrotoxicity | Markedly increased risk of acute kidney injury | Monitor renal function and electrolytes daily; consider liposomal amphotericin formulations |
| Neuromuscular blocking agents (suxamethonium, atracurium, rocuronium) | Potentiation of neuromuscular blockade | Prolonged respiratory paralysis and apnoea | Use with extreme caution; have calcium gluconate and ventilatory support available |
| Ciclosporin, Tacrolimus | Additive nephrotoxicity | Increased risk of acute kidney injury in transplant patients | Monitor renal function and drug levels of both agents frequently |
Other Notable Interactions
Beta-lactam antibiotics: When mixed in the same intravenous solution, beta-lactam antibiotics (penicillins and cephalosporins) can chemically inactivate amikacin. These drugs should never be mixed in the same infusion bag or syringe. However, when administered separately, beta-lactams and amikacin show synergistic antibacterial activity, which is clinically beneficial.
Non-steroidal anti-inflammatory drugs (NSAIDs): Indomethacin and other NSAIDs may reduce renal clearance of amikacin, leading to elevated plasma concentrations and increased risk of toxicity. Renal function and amikacin levels should be monitored more frequently when these agents are used concurrently.
Bisphosphonates: Concurrent use with intravenous bisphosphonates (such as zoledronic acid) may increase the risk of hypocalcaemia and renal impairment. Calcium and magnesium levels should be monitored.
Contrast media: Iodinated contrast agents used in radiological procedures can cause nephrotoxicity. The combination with amikacin increases the risk of contrast-induced nephropathy. Adequate hydration and timing of procedures are important considerations.
General anaesthetics: Enflurane, isoflurane, and other inhalational anaesthetics may potentiate the nephrotoxic effects of aminoglycosides. Postoperative monitoring of renal function is advisable.
What Is the Correct Dosage of Amikacin Macure?
The dosage of Amikacin Macure is individualised based on body weight, kidney function, the severity and site of infection, and therapeutic drug monitoring results. The standard dose for adults is 15 mg/kg/day, which can be given as a single daily dose or divided into two to three doses.
Amikacin dosing is complex and requires consideration of multiple patient-specific factors. Two main dosing strategies are used in clinical practice: conventional (multiple daily dosing) and extended-interval (once-daily) dosing. Both approaches aim to maximise bactericidal activity while minimising the risk of toxicity.
Adults
Standard Adult Dosing
Conventional dosing: 15 mg/kg/day administered as 7.5 mg/kg every 12 hours or 5 mg/kg every 8 hours by intramuscular injection or slow intravenous infusion over 30–60 minutes.
Extended-interval (once-daily) dosing: 15–20 mg/kg once daily by intravenous infusion over 30–60 minutes. This approach is increasingly preferred for many indications as it may improve efficacy (through higher peak concentrations) and reduce nephrotoxicity (through longer drug-free intervals allowing renal recovery).
Maximum daily dose: 1.5 g per day (or 15–20 mg/kg/day, whichever is lower).
Duration: Usually 7–10 days. Treatment beyond 10 days increases the risk of nephrotoxicity and ototoxicity substantially.
| Patient Group | Dose | Frequency | Key Considerations |
|---|---|---|---|
| Adults (normal renal function) | 15 mg/kg/day | Once daily or divided q12h | Max 1.5 g/day; base on actual body weight |
| Adults (renal impairment) | Adjusted based on CrCl | Extended intervals | Use nomograms; mandatory TDM; consider alternative agents |
| Neonates | 15 mg/kg loading, then 7.5 mg/kg | Every 12–24 hours | Adjust for gestational age; extended intervals for premature infants |
| Children (1 month – 12 years) | 15–20 mg/kg/day | Once daily or divided q8h | Children may require higher mg/kg doses due to larger volume of distribution |
| Elderly (≥65 years) | Based on CrCl and ideal body weight | Extended intervals preferred | Age-related renal decline; more frequent TDM; higher toxicity risk |
| Obese patients | Based on adjusted body weight | Per renal function | Use adjusted body weight (IBW + 0.4 × [TBW – IBW]); TDM essential |
Children
Paediatric dosing of amikacin requires careful attention to age, weight, and renal maturity. Neonates, particularly premature infants, have immature renal function and require extended dosing intervals. Full-term neonates are typically given a loading dose of 15 mg/kg followed by 7.5 mg/kg every 12 hours. Premature neonates may require dosing intervals of 18–24 hours or longer. Children older than one month generally receive 15–20 mg/kg/day, either as a single daily dose or divided into two to three doses. Paediatric patients often have a larger volume of distribution relative to body weight, which may necessitate higher mg/kg doses compared to adults.
Elderly
Elderly patients are at significantly increased risk of both nephrotoxicity and ototoxicity. Age-related decline in renal function means that standard doses may lead to drug accumulation and toxicity. Dosing should be based on estimated creatinine clearance (which may overestimate renal function in elderly patients when based on serum creatinine alone) and ideal body weight. Extended-interval dosing is generally preferred in elderly patients. Therapeutic drug monitoring should be performed more frequently, and treatment duration should be minimised.
Missed Dose
Since amikacin is administered in a hospital setting by healthcare professionals, missed doses are uncommon. If a dose is inadvertently missed, it should be given as soon as possible, and subsequent doses should be adjusted based on therapeutic drug monitoring results. The healthcare team will determine the appropriate timing for the next dose based on measured serum concentrations and the patient's clinical status.
Overdose
Overdose with amikacin can cause severe nephrotoxicity, ototoxicity, and neuromuscular blockade. Treatment of overdose includes immediate discontinuation of the drug, supportive care, and monitoring of renal function, electrolytes, and fluid balance. In severe cases, haemodialysis can effectively remove amikacin from the bloodstream (approximately 50% of a dose can be removed during a 4–6 hour dialysis session). Peritoneal dialysis is less effective. Neuromuscular blockade can be treated with calcium gluconate and mechanical ventilation as needed.
Patients with impaired kidney function require dose reduction or extended dosing intervals. Failure to adjust doses in renal impairment is one of the most common causes of aminoglycoside toxicity. Always check creatinine clearance before initiating therapy, and repeat monitoring at least every 48–72 hours during treatment. Use established nomograms or pharmacokinetic software for dose adjustment.
What Are the Side Effects of Amikacin Macure?
Like all aminoglycoside antibiotics, amikacin can cause side effects, the most clinically significant being nephrotoxicity (kidney damage) and ototoxicity (damage to hearing and balance). The frequency and severity of side effects are closely related to the dose, duration of treatment, and the patient's underlying health status.
The side effect profile of amikacin is well characterised from decades of clinical use. Most adverse effects are dose-related and can be minimised through appropriate dosing, therapeutic drug monitoring, and careful patient selection. The following classification is based on the standard system organ class approach used by the European Medicines Agency (EMA).
Very Common (>1/10)
- Elevated serum creatinine (subclinical nephrotoxicity)
- Elevated blood urea nitrogen (BUN)
Common (1/10 – 1/100)
- Nephrotoxicity (clinical kidney impairment with oliguria)
- Ototoxicity – cochlear (tinnitus, high-frequency hearing loss)
- Ototoxicity – vestibular (dizziness, vertigo, nystagmus)
- Nausea and vomiting
- Injection site reactions (pain, swelling, redness)
- Hypomagnesaemia (low magnesium)
Uncommon (1/100 – 1/1,000)
- Skin rash and urticaria
- Drug fever
- Headache
- Paraesthesia (tingling, numbness)
- Tremor
- Hypokalaemia (low potassium)
- Eosinophilia (increased eosinophils in blood)
Rare (<1/1,000)
- Neuromuscular blockade (respiratory paralysis)
- Anaphylactic reactions
- Acute renal failure requiring dialysis
- Permanent bilateral sensorineural deafness
- Optic neuropathy (visual disturbance)
- Pseudomembranous colitis (Clostridioides difficile infection)
- Agranulocytosis and thrombocytopenia
- Peripheral neuropathy
Nephrotoxicity in detail: Aminoglycoside-induced nephrotoxicity occurs due to accumulation of the drug in the proximal renal tubular cells, where it disrupts lysosomal function and causes cell death. The incidence ranges from 5% to 25% of treated patients, depending on the study and the definition used. Risk factors include advanced age, pre-existing renal disease, volume depletion, prolonged treatment, high trough concentrations, and concurrent use of other nephrotoxic drugs. Early detection through rising serum creatinine or the appearance of tubular casts in urine allows timely discontinuation and typically results in recovery of renal function.
Ototoxicity in detail: Cochlear damage from amikacin typically begins with high-frequency hearing loss (above the speech frequency range), which may go unnoticed initially. Progressive damage can extend to lower frequencies affecting speech discrimination. Vestibular damage can cause chronic imbalance and oscillopsia (visual disturbance during head movement). The mechanism involves damage to hair cells in the organ of Corti and the vestibular sensory epithelia through the generation of reactive oxygen species. Unlike nephrotoxicity, ototoxicity is often irreversible. The estimated incidence of clinically significant ototoxicity is 2–10%, but subclinical high-frequency hearing loss detected on audiometry may be more common.
Report the following symptoms to your medical team immediately: ringing in the ears (tinnitus), hearing changes, dizziness, difficulty with balance, decreased urine output, any new skin rash or itching, difficulty breathing, muscle weakness, or numbness/tingling in your extremities.
How Should You Store Amikacin Macure?
Amikacin Macure should be stored below 25°C and protected from light. Do not freeze. Once opened, the vial should be used immediately, and any unused solution should be discarded.
Proper storage of Amikacin Macure is essential to maintain the stability and potency of the medication. The solution for injection should be stored in its original packaging to protect it from light. It should be kept at room temperature, not exceeding 25°C (77°F), and must not be frozen as this can cause degradation of the active substance.
The solution should be clear and colourless to pale yellow. Before administration, the solution should be visually inspected for particulate matter and discolouration. Do not use the solution if it appears cloudy, contains particles, or has changed colour to a darker shade. A pale straw or light yellow colour is normal and does not indicate reduced potency.
Once the vial is opened, the contents should be used immediately. Amikacin Macure does not contain preservatives, so any unused portion should be discarded. If diluted for intravenous infusion, the diluted solution is typically stable for up to 24 hours at room temperature in compatible infusion fluids (0.9% sodium chloride or 5% glucose), but local hospital pharmacy guidelines should be followed regarding in-use stability.
As with all medications, Amikacin Macure should be kept out of the sight and reach of children. Do not use after the expiry date stated on the vial and outer packaging. The expiry date refers to the last day of that month. Do not dispose of medications via wastewater or household waste – follow local regulations for the disposal of pharmaceutical waste.
What Does Amikacin Macure Contain?
Amikacin Macure contains amikacin (as amikacin sulfate) as the active ingredient, along with sodium citrate, sodium metabisulfite, sulfuric acid, sodium hydroxide, and water for injections as excipients.
The active substance in Amikacin Macure is amikacin, present in the form of amikacin sulfate. Each millilitre of solution contains 250 mg of amikacin (equivalent to approximately 333 mg of amikacin sulfate). Amikacin is a semisynthetic derivative of kanamycin A, first developed in 1972 by modification of the 1-amino group of the 2-deoxystreptamine moiety. This structural modification confers resistance to most of the aminoglycoside-modifying enzymes produced by resistant bacteria, giving amikacin its broader spectrum of activity compared to gentamicin and tobramycin.
The excipients (inactive ingredients) include:
- Sodium citrate: Acts as a buffer to maintain the pH of the solution within the optimal range for stability and compatibility
- Sodium metabisulfite: An antioxidant that prevents oxidative degradation of the active substance. Note: patients with sulfite sensitivity (particularly those with asthma) may experience hypersensitivity reactions including bronchospasm
- Sulfuric acid and/or sodium hydroxide: Used for pH adjustment to achieve the target pH of approximately 3.5–5.5
- Water for injections: The solvent vehicle, ensuring the solution is isotonic and suitable for parenteral administration
Amikacin Macure contains sodium metabisulfite, which may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is low but is seen more frequently in asthmatic patients. Healthcare providers should be aware of this excipient and ask patients about sulfite sensitivity before administration.
Frequently Asked Questions About Amikacin Macure
Amikacin Macure is an aminoglycoside antibiotic used to treat serious bacterial infections caused by gram-negative organisms. It is commonly used for severe urinary tract infections, respiratory tract infections, septicemia (bloodstream infections), bone and joint infections, and intra-abdominal infections. It is typically reserved for infections caused by bacteria resistant to other aminoglycosides like gentamicin.
Amikacin Macure is administered by injection, either intravenously (IV) as a slow infusion over 30–60 minutes, or intramuscularly (IM). It is given in a hospital setting under medical supervision. The drug is not available in oral form because aminoglycosides are poorly absorbed from the gastrointestinal tract.
The most serious side effects are nephrotoxicity (kidney damage) and ototoxicity (damage to hearing and balance). Kidney damage is usually reversible if the drug is stopped early, but hearing loss may be permanent. Neuromuscular blockade is a rare but potentially life-threatening side effect. Regular monitoring of kidney function and drug levels is essential during treatment.
Amikacin has a narrow therapeutic index, meaning the difference between an effective dose and a toxic dose is small. Therapeutic drug monitoring (TDM) helps ensure blood levels are high enough to kill bacteria but not so high that they damage the kidneys or ears. Peak levels (typically 20–35 mg/L) and trough levels (below 5–10 mg/L) are measured to guide dosing adjustments.
Amikacin should be avoided during pregnancy unless the infection is life-threatening and no safer alternative is available. Aminoglycosides cross the placenta and may cause irreversible damage to the fetal auditory nerve, potentially resulting in hearing loss in the newborn. If use is absolutely necessary, the lowest effective dose should be used for the shortest possible duration with close monitoring.
A typical course of amikacin treatment lasts 7 to 10 days for most infections. Treatment duration should be kept as short as clinically effective to minimise the risk of nephrotoxicity and ototoxicity. For uncomplicated infections, 7 days may be sufficient, while complicated infections may require longer courses. Duration should always be guided by clinical response and culture results.
References
All medical information in this article is based on peer-reviewed research and international medical guidelines. The following sources were used:
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List, 2023. Geneva: WHO; 2023. Amikacin is classified as a Watch group antibiotic.
- European Medicines Agency (EMA). Amikacin – Summary of Product Characteristics. European public assessment reports. Last updated 2024.
- U.S. Food and Drug Administration (FDA). Amikacin Sulfate Injection – Prescribing Information. Reference listed drug labelling.
- British National Formulary (BNF). Amikacin. NICE Evidence Services. Accessed January 2026.
- Tamma PD, Aitken SL, Bonomo RA, et al. Infectious Diseases Society of America (IDSA) Antimicrobial-Resistant Treatment Guidance. Clin Infect Dis. 2023;76(Supplement_2):e169–e233.
- Craig WA. Optimizing aminoglycoside use. Crit Care Clin. 2011;27(1):107–121. doi:10.1016/j.ccc.2010.09.006
- Avent ML, Rogers BA, Cheng AC, Paterson DL. Current use of aminoglycosides: indications, pharmacokinetics and monitoring for toxicity. Intern Med J. 2011;41(6):441–449. doi:10.1111/j.1445-5994.2011.02452.x
- Huth ME, Ricci AJ, Bhatt S. Aminoglycoside ototoxicity: mechanisms and prevention. Expert Opin Drug Saf. 2011;10(5):715–722. doi:10.1517/14740338.2011.584901
- Lopez-Novoa JM, Quiros Y, Vicente L, et al. New insights into the mechanism of aminoglycoside nephrotoxicity: an integrative point of view. Kidney Int. 2011;79(1):33–45. doi:10.1038/ki.2010.337
- Drusano GL, Ambrose PG, Bhavnani SM, et al. Back to the future: using aminoglycosides again and how to dose them optimally. Clin Infect Dis. 2007;45(6):753–760. doi:10.1086/520991
Editorial Team
This article was written and medically reviewed by the iMedic Medical Editorial Team, comprising licensed physicians and pharmacists specialising in pharmacology, infectious disease, and clinical medicine.
iMedic Medical Editorial Team – Specialists in pharmacology and infectious disease with documented academic background and clinical experience.
iMedic Medical Review Board – Independent panel of medical experts who review all content according to international guidelines (WHO, EMA, FDA, BNF, IDSA).
Evidence standard: All medical claims in this article have evidence level 1A, the highest quality of evidence based on systematic reviews and meta-analyses of randomized controlled trials and international guideline recommendations.
Conflict of interest: The editorial team has no financial relationships with pharmaceutical companies. iMedic receives no commercial funding and does not accept pharmaceutical advertising.
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