Amikacin disulfate (BAY-416651 sulfate) is a semi-synthetic aminoglycoside antibiotic derived from kanamycin A.

Amikacin sulfate has high affinities for 16S rRNA of the bacterial 30S ribosome, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth. [1] Amikacin is active in vitro against Pseudomonas species, [2] Escherichia coli[3], Proteus species (indole-positive and indole-negative), Providencia species, Klebsiella-Enterobacter-Serratia species, Acinetobacter (formerly Mima-Herellea) species, and Citrobacter freundii.[4] [5] In vitro studies have shown that amikacin sulfate combined with a beta-lactam antibiotic acts synergistically against many clinically significant Gram-negative organisms. In vitro studies have shown that amikacin sulfate combined with beta-lactam antimicrobial agents including moxalactam or piperacillin acts synergistically against many clinically significant Gram-negative organisms. [6]

Amikacin (80 mg/kg i.v.) significantly reduced pseudomonal densities within aortic vegetations compared to controls in the experimental rabbit endocarditis model. In addition, amikacin given once daily is still more effective than the twice-daily regimen. [7] Amikacin given alone at a dose of 50 mg/kg, in one, two, or three divided doses, showed remarkable activity in model of Mycobacterium avium complex infections in beige mice. Addition of clofazimine increased the activity significantly. [8]