Kacin® is a semi-synthetic aminoglycosidic antibiotic, indicated in the short-term
treatment of serious infections due to susceptible strains of Gram-negative bacteria.
Kacin® is effective in bacterial septicemia (including neonatal sepsis); in serious
infections of the respiratory tract, bones and joints, central nervous system
(including meningitis) and skin and soft tissue; intra abdominal infections (including
peritonitis); and in burns and post operative infections (including postvascular
surgery). Kacin® is also effective in serious complicated and recurrent urinary tract
infections due to susceptible Gram-negative organisms. Kacin® may be considered
as initial therapy in suspected Gram-negative infections and therapy may be
instituted before obtaining the results of susceptibility. Kacin® is also effective in
infections caused by Gentamycin and/or Tobramycin resistant strains of
Gram-negative organisms. Kacin® has also been shown to be effective in
Staphylococcal infection and may be considered as initial therapy under certain
condition in the treatment of known suspected Staphylococcal disease such as,
severe infections where the causative organism may either a Gram-negative
bacterium or Staphylococcus infection due to susceptible strains of Staphylococcal /
Gram-negative infections. In certain severe infections such as neonatal sepsis,
concomitant therapy with a penicillin type drug may be indicated because of the
possibility of infections due to Gram positive organism such as streptococci or
pneumococci.
Dosage and Administration
Adults and children: 15 mg/ kg/ day in two equally divided doses (equivalent to
500 mg bid in adults). Use of the 100 mg/ 2 ml strength is recommended for
children for the accurate measurement of the appropriate dose.
Neonates and premature children: An initial loading dose of 10 mg/kg followed
by 15 mg/ kg/ day in two equally divided doses.
Elderly: Doses should be adjusted under impaired renal function in elderly:
Life-threatening infections and/ or those caused by pseudomonas: The adult
dose may be increased to 500 mg every eight hours but should neither exceed 1.5
gm/ day nor be administered for a period longer than 10 days. A maximum total
adult dose of 15 gm should not be exceeded.
Urinary tract infections: (Other than pseudomonal infections): 7.5 mg/kg/ day in
two equally divided doses (equivalent to 250 mg bid in adults).
Impaired renal function: In patient with impaired renal function the daily dose
should be reduced and / or the intervals between doses increased to avoid
accumulation of the drug. Simple doses schedule for renal impairment is given
below:
Renal function Dose schedule
Mild impairment 500 mg every 18 hours
Moderate impairment 500 mg every 24 hours
Severe impairment 250 mg every 24 hours
Administration:
Intramuscular or intravenous administration: For most infections the intramuscular
route is preferred, but in life threatening infections, or in patients in whom
intramuscular injection route is not feasible the intravenous route may be used.
Intraperitoneal use: Kacin® may be used as an irrigant after recovery from
anaesthesia in concentration of 0.25%.
Other route of administration: Kacin® in concentration of 0.25% may be used
satisfactorily as an irrigating solution in abscess cavities, the pleural space, the
peritoneum and the cerebral ventricles.
Contra-indications, warnings, etc.
Contra-indications: A history of hypersensitivity or serious toxic reaction to
aminoglycosides may contraindicate the use of Kacin®.
Use in pregnancy and lactation:
The safety of Kacin® in pregnancy has not yet been established.
Side-effects:
When the recommended precautions and dosages are followed the
incidence of toxic reactous, such as tinnitus vertigo, and partial reversible or
irreversible deafness, skin rash, drug fever, headache, paraesthesia, nausea and
vomiting is low. Urinary signs of renal irritation, azotaemia and oliguria have been
reported
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