AMIKACIN, PEAK LEVEL

Code
000.0000
Name
AMIKACIN, PEAK LEVEL
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
Amikin; Aminoglycosides
CPT Codes
80150
Site
SBMF
Reference Test
29192
ATLAS Test Code

Specimen Information

Type

Red top (serum) or Green top (lithium heparin) tube

Volume

0.5 ml

Transport Info

Centrifuge and immediately transfer serum or plasma to separate plastic tube
Frozen

Fasting Required?
False
Patient Instructions

Reference Range

Peak Level: 20-30 µg/mL

Critical High: >35 µg/mL

Methodology

Fluorescence Polarization

Clinical Significance

Monitor dosage used in the treatment of gram negative infections.

Amikacin is effective in the treatment of serious gram-negative infections and is particularly useful in those involving strains resistant to all the other aminoglycosides. Amikacin is probably the aminoglycoside of first choice when gentamicin resistance is strongly suspected. As with other aminoglycosides, there is a narrow margin between therapeutic effectiveness and toxicity. Amikacin should be used with caution in patients with depressed renal function. Strong correlations have been shown between serum levels and both therapeutic effect and toxicity in specific patient types. Peak serum levels of amikacin in the range of 20 to 25 mcg/mL are suggested for optimal therapeutic effectiveness. Persistently elevated peak concentrations (30-35 mcg/mL) have been shown to cause renal and central nervous system toxicity. Nephrotoxicity takes the form of damage to the proximal renal tubules, and is associated with impaired renal function. Central nervous system toxicity is most often manifested as damage to the vestibular and auditory branches of the eighth cranial nerve. Trough levels offer a more discrete indication of impending toxicity since they more closely correspond to tissue levels and are less affected by sampling errors. Slowly rising trough levels have been shown to correspond to tissue accumulation of the drug, and trough levels greater than 10 µg/mL have been associated with renal failure in some patients.

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