Amikacin is a semisynthetic aminoglycoside antibiotic derived from kanamycin A, used to treat severe bacterial infections caused by Gram-negative and some Gram-positive organisms, particularly in cases resistant to other aminoglycosides. It works by binding to the bacterial 30S ribosomal subunit, inhibiting protein synthesis, leading to bactericidal activity. Developed in the 1970s to overcome kanamycin and gentamicin resistance, amikacin was modified to resist enzymatic inactivation by bacterial aminoglycoside-modifying enzymes, making it effective against multidrug-resistant strains. Administered mainly by intravenous or intramuscular injection, it remains a critical option in hospitals for treating complicated infections like sepsis, respiratory tract infections, urinary tract infections, and bone infections, though careful monitoring is required to avoid nephrotoxicity and ototoxicity.
