EXPLODING BACTERIAMed Decision Speed Tools
aminoglycosidesUnverified

Amikacin

Generic, Amikin®
?Pregnancy?Breastfeeding?Warfarin
Open the full CAP page →
Aztreonam○Pick onerequired
+
Fluoroquinolone○Pick onerequired
+
Aminoglycoside○Pick onerequired
±
Anti-MRSA○Optionalif risk
Select
Aztreonam
???
Do NOT give aztreonam to those with a Ceftazidime₃ allergy (shared side chain → cross-reactivity).
2 g IV q8h
IV / IM
1 g vial2 g vial
Inhaled (Cayston®)
75 mg
BrandsGeneric, Azactam®, Cayston® (inhaled)
View full Aztreonam page →
+
AND Select
Levofloxacin
???
750 mg IV/PO q24h
Liquid
25 mg/mL oral solution
Tablets
250 mg500 mg750 mg
IV
5 mg/mL (premix)25 mg/mL (vial)
BrandsGeneric, Levaquin®
View full Levofloxacin page →
+
AND Choose ONE Aminoglycoside
Amikacin
???
Requires drug level monitoring.
15–20 mg/kg IV q24h
IV / IM
250 mg/mL50 mg/mL
BrandsGeneric, Amikin®
View full Amikacin page →
Gentamicin
???
Requires drug level monitoring.
5–7 mg/kg IV q24h
IV / IM
10 mg/mL40 mg/mL
BrandsGeneric, Garamycin®
View full Gentamicin page →
Tobramycin
???
Requires drug level monitoring.
5–7 mg/kg IV q24h
IV / IM
10 mg/mL40 mg/mL
Inhaled (Tobi®)
300 mg/5 mL
BrandsGeneric, Tobi® (inhaled)
View full Tobramycin page →
±
Consider ONE Anti-MRSAONLY if risk factors
Add anti-MRSA only for a real risk factor — it is not routine in CAP.
Risks: prior MRSA (infection, colonization, or positive nasal PCR); hospitalization or IV antibiotics ≤90 days; severe, necrotizing, or cavitary pneumonia; empyema; recent influenza; ESRD/dialysis; injection drug use.
Negative nasal PCR (NPV ~95–99%) → reasonable to withhold or stop.
VancomycinMRSA
???
Monitor: target AUC/MIC 400–600; check a level before the 4th dose.
15–20 mg/kg IV q8–12h
IV
500 mg750 mg1 g1.25 g5 g
Capsules — PO, C. diff only
125 mg250 mg
BrandsGeneric, Vancocin®
View full Vancomycin page →
LinezolidMRSA · VRE
???
600 mg IV/PO q12h
Tablets
600 mg
Liquid
100 mg/5 mL
IV
600 mg/300 mL
BrandsGeneric, Zyvox®
View full Linezolid page →
Other regimens for this scenario don't include Amikacin — see the full page for the complete algorithm.

Drug Info

IV / IM
250 mg/mL50 mg/mL
BrandsGeneric, Amikin®

Safety

?PregnancyNot yet reviewed.
?BreastfeedingNot yet reviewed.
?WarfarinNot yet reviewed.