Amikacin is an approved antibiotic used for treating severe bacterial infections. In the test tube it is active against Mycobacterium avium intracellulare (MAI) organisms and it is being studied in combination with other drugs for treating the condition. It is administered by intramuscular or intravenous injection. Side-effects can include hearing, balance and kidney abnormalities.

Amikacin is also known as amikacin sulphate. It is manufactured by Bristol-Myers Squibb under the tradename Amikin.

A liposomal version of amikacin has been developed by Nexstar Pharmaceuticals under the tradename Mikasome. A study of liposomal amikacin in nine people with non-tuberculous mycobacteria (mostly MAI infection), has been reported. Dosage was 20mg/kg on alternate days for 2 weeks. Of the nine, one patient discontinued, one developed renal failure, and one an anaphylactic reaction to the treatment. Of the other six, five seroconverted to a negative blood culture and all six responded clinically. Of four patients who remained on maintenance therapy, all relapsed between 0.5 and 5 months after induction. All were successfully re-induced on treatment at 30 or 40mg/kg on alternate days. One other of these four developed kidney failure, which responded to cessation of non-steroidal anti-inflammatory drugs (NSAIDs). No other toxicities were noted.

References

Nelson M et al. Liposomal amikacin (LA) for the treatment of non-tuberculous mycobacteria (NTM) in HIV disease. Twelfth World AIDS Conference, Geneva, abstract 22170, 1998.