ABSTRACT
The water-soluble acetylation product of the 2-deoxystreptamine moiety of kanamycin is amikacin, which has similar antimicrobial activity to the parent compound. However, of the known enzyme systems capable of biotransforming aminoglycoside antibiotics, only 6’-N-acetyltransferase, 4,-O-adenyltransferase, and 3’-O-phospho-transferase inactivate amikacin, hence, the broad spectrum of activity for amikacin against Gram-negative bacteria. There have been several clinical studies into the general ototoxicity of amikacin and its comparative toxicity with other aminoglycoside antibiotics. Lane et al. reported on the case records of 1548 patients resulting from a phase II and phase III study of amikacin in the US Specific animal experimentation with amikacin is relatively limited in comparison to the other aminoglycoside antibiotics. Theopold compared, by scanning electron microscopy, the effects of amikacin with gentamicin and tobramycin on the Organ of Corti in guinea pigs. The dosages used for all three of these aminoglycosides were excessively high compared to those found in normal clinical situations.
