kanamycin (Kantrex)
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Introduction
Tradename: Kantrex.
Dosage
15 mg/kg up to 1500 mg/day IV/IM divided every 8-12 hours
Dosage adjustment in renal failure
Table
| creatinine clearance | dosage (QD dosing) |
|---|---|
| > 80 mL/min | 15 mg/kg |
| 60-80 mL/min | 12 mg/kg |
| 40-60 mL/min | 7.5 mg/kg |
| 30-40 mL/min | 4 mg/kg |
| 20-30 mL/min | 7.5 mg/kg every 48 hours |
| 10-20 mL/min | 4 mg/kg every 48 hours |
| < 10 mL/min | 3 mg/kg every 48 hours |
Adverse effects
- ototoxicity
- tinnitus
- vestibular toxicity may occur up to 2-3 months after stopping drug
- nephrotoxicity
- eosinophilia
- leukopenia
- cholestasis
- neuromuscular blockade
- therapeutic drug monitoring
Laboratory
- kanamycin in serum/plasma (EDTA)
- for patients on penicillin, freeze if not analyzed in 4-6 hours
- collect peak level 1 hour after dose
- methods: RIA, MB, HPLC, GLC, REA, EIA, FPIA
- interferences:
- MB: coadministration of other antibiotics; penicillins & cephalosporins may be inactivated with commercially available beta lactamase to minimize this interference
- antibiotic susceptibility kanamycin