Kanamycin

Indications
 Oral
Suppression of intestinal flora
Adult: Pre-operative use: 1 g every hr for 4 hr, then 1 g every 6 hr for 36-72 hr.
Renal impairment: Adjustments in dose and/or dosing frequency may be required.
Oral
Hepatic encephalopathy
Adult: 8-12 g daily in divided doses.
Renal impairment: Adjustments in dose and/or dosing frequency may be required.
Parenteral
Susceptible Gram-negative and staphylococcal infections
Adult: 15 mg/kg daily IM or as IV infusion of a 0.25-0.5% solution over 30-60 minutes. Max: 1.5 g daily in 2-4 divided doses. Recommended treatment duration: Not more than 7-10 days for acute infections. Not to exceed a cumulative dose of 10 g. For chronic bacterial infections: 3-4 g wkly, given as 1 g on alternate days or 1 g bid on 2 days each wk. Max cumulative dose: 50 g. Prolonged use is not recommended due to risk of nephrotoxicity.
Child: 15 mg/kg daily IM or as IV infusion of a 0.25-0.5% solution over 30-60 min. Max daily dose: 1.5 g in 2-4 divided doses. Treatment duration: 7-10 days. Max cumulative dose: 10 g.
Renal impairment: Adjustments in dose and/or dosing frequency may be required.
Intramuscular
Penicillin-resistant gonorrhoea
Adult: 2 g as a single dose.
Renal impairment: Adjustments in dose and/or dosing frequency may be required.
Intramuscular
Treatment and prophylaxis of neonatal gonococcal infections
Child: Infants born to mothers with gonorrhoea: 25 mg/kg as a single dose. Max: 75 mg.
Renal impairment: Adjustments in dose and/or dosing frequency may be required.
Intraperitoneal
Peritonitis or peritoneal contamination during surgery
Adult: Dilute 500 mg in 20 mL sterile distilled water and instill into the peritoneal cavity.
Renal impairment: Adjustments in dose and/or dosing frequency may be required.
Inhalation
Susceptible Gram-negative and staphylococcal infections
Adult: 250 mg 2-4 times daily, given via nebulisation. Dilute 250 mg in 3 mL 0.9% sodium chloride.
Renal impairment: Adjustments in dose and/or dosing frequency may be required.
Irrigation
Irrigation of body cavities
Adult: Instil 0.25% solution into abscess cavities, pleural space, or peritoneal or ventricular cavities.
Renal impairment: Adjustments in dose and/or dosing frequency may be required.
Contraindications
 Hypersensitivity. GI ulceration (oral).
Warnings / Precautions
 Renal impairment, dehydration, previous exposure to ototoxic drugs; preexisting tinnitus, vertigo or subclinical hearing loss. Parkinsonism, myasthenia gravis. Infants, neonates, elderly. Pregnancy, lactation.
Adverse Reactions
 Pain, inflammation, bruising, haematoma at inj site; GI disturbances; malabsorption of fat.
Potentially Fatal: Neuromuscular blockade; nephrotoxicity; ototoxicity.
Drug Interactions
 Synergistic effects with ampicillin, benzylpenicillin and other β-lactam antibiotics. May reduce renal excretion of zalcitabine.
Potentially Fatal: Increased risk of ototoxicity with ethacrynic acid and furosemide. Increased risk of nephrotoxicity with cephalosporins, ciclosporin, cisplatin, vancomycin, hydrocortisone and indomethacin. Potentiates effects of neuromuscular blocking agents.
See Below for More kanamycin Drug Interactions
Mechanism of Actions
 Kanamycin irreversibly binds to 30S, and to some extent 50S, ribosomal subunits of susceptible bacteria disrupting protein synthesis, thus rendering the bacterial cell membrane defective.
Absorption: <1% is absorbed from the GI tract but may be markedly increased if GI mucosa is inflamed or ulcerated (oral); peak plasma concentrations after 1 hr (IM).
Distribution: Present in cord blood and breast milk.
Excretion: Via urine by glomerular filtration (as unchanged drug); 3 hr (elimination half-life).
Storage Conditions
 Intramuscular: Store at 20-25°C. Parenteral: Store at 20-25°C.
ATC Classification
 J01GB04 - kanamycin ; Belongs to the class of other aminoglycosides. Used in the systemic treatment of infections.
A07AA08 - kanamycin ; Belongs to the class of antibiotics. Used in the treatment of intestinal infections.
S01AA24 - kanamycin ; Belongs to the class of antibiotics. Used in the treatment of eye infections.
Storage
 Intramuscular: Store at 20-25°C. Parenteral: Store at 20-25°C.
Available As
  • Kanamycin 1000 mg
  • Kanamycin 500 mg
  • Kanamycin 750 mg

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