Amikacin Peak

Test Code

AMIKP

Alias/See Also

Amikin Peak

CPT Codes
80150

Preferred Specimen

SST or PST

Minimum Volume

1 mL

Instructions

Serum Only, heparinized plasma not acceptable.

To obtain a serum amikacin concentration that best represents the peak tissue level, draw the sample one hour after an intramuscular injection, 30 minutes after ending a 30- minute intravenous infusion, or immediately after a 60-minute intravenous infusion. Collect a trough sample just before the next scheduled dose. When adjusting dosage, measure peak and trough levels during the same dosing intervals.

Transport Container

Serum (gold or red top tube)

Transport Temperature

Room Temperature or Refrigeration

Specimen Stability

Room Temperature - 4 hours; Refrigeration - 7 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Quantity Not Sufficient, EDTA (purple top tube) contamination, IV contamination

Methodology
Turbidimetric

Setup Schedule

Daily upon receipt

Report Available

Upon completion of analysis

Limitations

Samples containing amikacin in combination with kanamycin cannot be reliably quantitated by this assay. High dosages of penicillins and/or cephalosporins are known to inactivate amikacin in vitro.

Reference Range

Therapeutic Peak Range: 15 - 25 ug/mL

Clinical Significance

Amikacin is an aminoglycoside used to treat severe blood infections by susceptible strains of gram-negative bacteria. Aminoglycosides induce bacterial death by irreversibly binding bacterial ribosomes to inhibit protein synthesis. Amikacin is minimally absorbed from the gastrointestinal tract, and thus can been used orally to reduce intestinal flora.

Peak serum concentrations are seen 30 minutes after intravenous infusion, or 60 minutes after intramuscular administration. Serum half-lives in patients with normal renal function are generally 2 to 3 hours. Excretion of aminoglycosides is principally renal, and all aminoglycosides may accumulate in the kidney at 50 to 100 times the serum concentration.

Toxicity can present as dizziness, vertigo, or, if severe, ataxia and a Meniere disease-like syndrome. Auditory toxicity may be manifested by simple tinnitus or any degree of hearing loss, which may be temporary or permanent, and can extend to total irreversible deafness. Nephrotoxicity is most frequently manifested by transient proteinuria or azotemia, which may occasionally be severe. Aminoglycosides also are associated with variable degrees of neuromuscular blockade leading to apnea.

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.