Kanamycin

Administration

• Type: Aminoglycoside
• Dosage Forms: 1 g/3 mL
• Routes of Administration: IM, IV

Adult Dosing

• Bacterial Infections: 7.5mg/kg IM/IV q12h
  • For obese patients, use adjusted wt of IBW + 0.4 x (ABW - IBW)
  • Adjust dose based on serum levels

Pediatric Dosing

• Bacterial Infections: 7.5mg/kg IM/IV q12h

Special Populations

• Pregnancy Risk Factor: D

Renal Dosing

• CrCl 50-80: give q12-24h
• CrCl 10-50: give q24-72h
• CrCl <10: give q48-72h

Contraindications

• Allergy to class/drug
• Caution if:
  • sulfite hypersensitivity
  • renal impairment, dehydration, concurrent nephrotoxic agent use
  • impaired auditory or vestibular function, concurrent ototoxic or neurotoxic agents
  • neuromuscular disease
  • electrolyte abnormalities
  • prolonged use, high dose treatment
  • neonates/infants or elderly

Adverse Reactions

• Nephrotoxicity
  • Increased risk with renal impairment, high dose, prolonged treatment
  • Monitor renal function, peak/trough levels
• Neuromuscular Blockade
  • Risk of respiratory paralysis possible with any route of administration

Black Box Warnings

• Neurotoxicity/Ototoxicity
  • Increased risk with renal impairment, high dose, prolonged treatment

Serious

• Nephrotoxicity
• Ototoxicity (auditory or vestibular)
• Neurotoxicity, neuromuscular blockade

Common

• Hearing loss, tinnitus, vertigo
• BUN, creatinine elevated

Pharmacology

• Half-life: 2-4 hrs
• Metabolism: CYP 450
• Excretion: Urine

Mechanism of Action

• Interferes with protein synthesis in bacterial cell by binding to ribosomal subunit

References

<UpToDate, MicroMedex/>

Authors

Kristina Shigyo, Ross Donaldson, Kaoru Itakura, Claire, Neil Young, Daniel Ostermayer