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Back in the late 1960s, researchers noticed growing worries about bacterial resistance to traditional aminoglycosides. Streptomycin and gentamicin became less reliable, sending out a call for tougher options. Scientists stepped up to the plate and came up with amikacin, modifying kanamycin by attaching an L-a-hydroxy-g-amino-a-methylbutyryl group to the molecule. This small tweak made a big difference in activity against stubborn bugs. When doctors put amikacin sulfate into real-world use in the early 1970s, hospitals finally had another weapon for infections that laughed off other drugs.
Amikacin sulfate stands as a powerful aminoglycoside antibiotic widely employed for managing severe bacterial infections, especially those caused by Gram-negative bacteria. Unlike many other antibiotics that falter in the presence of resistance enzymes, amikacin plows through and usually works where gentamicin fails. You’ll find it in sterile injectable form at most healthcare institutions, where it’s relied upon for pneumonia, sepsis, complicated urinary tract infections, and intra-abdominal infections. Sometimes, doctors pair it with other antibiotics, squeezing out every bit of benefit to treat tough cases.
This antibiotic comes as a white to off-white crystalline powder, pretty unremarkable at first glance. It dissolves in water, a practical quality for injection. The chemical formula is C22H43N5O13•2H2SO4, and its molecular weight tips the scale around 781.8. The compound holds up well to light and air, but moisture still poses a risk if left exposed. As an aminoglycoside, its structure includes an aminocyclitol ring linked to several amino sugars, which help it bind to bacterial ribosomes with tenacity.
Each vial contains amikacin sulfate equivalent to 250 mg or 500 mg amikacin base, dissolved in sterile water. pH levels are adjusted to favor stability—usually from 3.8 to 5.5. Labels must state strength clearly, cite the active ingredient’s equivalence, and bear batch numbers, expiry dates, and detailed storage requirements. If a package skips on these details, healthcare workers can’t safely administer doses or trace sources in case something goes wrong, which sets up avoidable risk.
Manufacturers start by fermenting Streptomyces kanamyceticus bacteria to yield kanamycin. Then, through semi-synthetic processes, they acylate kanamycin with (S)-4-amino-2-hydroxybutyric acid, giving rise to amikacin. The sulfate salt comes into play in a later step, improving water solubility and allowing for stable injection solutions. Pharmaceutical-grade purification ensures no rogue endotoxins sneak in, and the final rounds of filtration cut out particulates that might trigger dangerous reactions after injection.
Chemists poke and prod aminoglycosides to see which positions on the molecule muscle up resistance. Amikacin’s acylation at the C1-amino group shields it from most bacterial aminoglycoside-inactivating enzymes. Some labs explore further substitutions to enhance the molecule. For example, swapping out certain side chains can either tune activity or help tackle even rarer resistant strains. The community keeps tinkering with amikacin’s backbone, searching for derivatives that could outmaneuver the next wave of resistant organisms.
You may hear pharmacists or clinicians mention Amikin, Biklin, or Likacin, all referring to this same compound. The generic name “amikacin sulfate” appears on drug formularies around the world. A few countries opt for regional trade names, but the core drug stays the same. The U.S. Pharmacopeia sets tight standards to keep brand and generic forms bioequivalent, so switching between them doesn’t set off alarms about dosing or safety.
Dosing must account for kidney function, as amikacin’s elimination hinges on glomerular filtration. That’s why lab technicians keep close tabs on renal panels alongside drug trough levels, especially for elderly patients. To avoid ototoxicity and nephrotoxicity, prescribers follow guidelines from the CDC and World Health Organization for monitored use and strict dosing intervals. The compounding process has to be spot-on, with meticulous sterile technique and regular validation checks. Any break in protocol, like a contaminated batch or a labeling mix-up, immediately goes under review to prevent harm.
Doctors often reach for amikacin in medical settings where bacteria duck around weaker antibiotics. Tertiary hospitals rely on it for multidrug-resistant tuberculosis and Pseudomonas aeruginosa infections. Intensive care units may deploy it early-on for ventilator-associated pneumonia if cultures suggest susceptibility. Veterinary medicine draws on amikacin’s power as well, using it in dogs, horses, and exotics where life-threatening infections rear up. Inside laboratories, researchers employ it to maintain selective pressure against bacterial contamination in cell culture work.
Pharmaceutical scientists keep the gears turning by examining how bacteria develop new resistance tricks against amikacin. Studies probe the structure of ribosomal RNA to understand binding and tweak the molecule for better uptake or reduced toxicity. In global health, some research projects tackle the persistent challenge of access—figuring out ways to provide amikacin in low-resource settings without sacrificing purity or safety. Others work with novel drug delivery systems, such as liposomal or nanoparticle formulations, looking for longer half-lives and fewer side effects.
Ototoxicity stands as the most pressing issue. Patients exposed to high doses for prolonged courses risk losing hearing, sometimes irreversibly. That’s not just a statistic; many nurses and physicians see the fallout first-hand, especially in older adults and neonates. Researchers have mapped out which cochlear hair cells fall victim to aminoglycoside buildup. Nephrotoxicity also commands attention, as the drug concentrates in renal tubular cells and damages them over time. Modern protocols limit cumulative exposure, and some labs investigate antioxidants or chelators that might block the worst of these toxic effects.
Amikacin’s story hasn’t reached its last chapter. The ongoing rise in antimicrobial resistance means healthcare systems won’t shelve this antibiotic anytime soon. New delivery routes like inhaled amikacin target lung infections directly, promising fewer systemic side effects. Pharmacologists test out combinations with other antibiotics, aiming for a one-two punch against entrenched hospital pathogens. Genetic sequencing helps tailor therapy—identifying which organisms still cave to amikacin and avoiding pointless dosing. Many hope that, with solid stewardship, smart modifications, and expanded access, amikacin will continue to serve as a reliable cornerstone in the antibiotic arsenal for years to come.
Walking through a hospital or clinic these days, the conversation about antibiotic resistance feels impossible to miss. Doctors and nurses talk about “superbugs” that laugh at medications from years past. In my days volunteering at a city hospital, I heard “amikacin” mentioned more than once when folks faced infections no one wanted to mess with. Amikacin sulfate often steps up when other antibiotics have lost their punch, especially with certain hard-to-treat infections caused by what are known as Gram-negative bacteria.
Doctors reach for amikacin sulfate mostly when regular treatments fall short. It’s commonly given by injection, hitting the bloodstream fast. Hospital teams use it to fight lung infections (like hospital-acquired pneumonia), urinary tract infections, bone infections, and sometimes even blood infections (sepsis) that don’t improve with standard drugs. Klebsiella, Pseudomonas, and Enterobacter—these are names patients don’t want to see in lab results. Amikacin gets called in precisely because those bugs have become stubborn.
Amikacin belongs to the aminoglycoside family, a group known for handling serious infections. In clinics with rising antibiotic resistance rates, this medicine does not blend in with milder options; it stands out when lives are at stake, especially in intensive care or oncology wards where immune systems throw up the white flag.
Amikacin’s value comes with hard choices. Too much, or prolonged use, risks damage to hearing and kidneys—doctors call it “ototoxicity” and “nephrotoxicity.” I remember hospital pharmacists walking rounds with portable computers, entering exact weights and lab numbers to keep doses safe for each patient. They didn’t cut corners. They took hearing tests seriously, watching for any sign that the medicine might be causing harm. It’s a reminder that every time someone gets amikacin, it follows serious discussion, not autopilot prescription.
Penicillin changed the world, but bacteria don’t stay static; they adjust, evolve, and pick up tricks to survive. By 2023, the World Health Organization called resistance “one of the top threats to global health.” In America, the CDC tracks more than 2.8 million antibiotic-resistant infections every year. Places where antibiotics flow freely without prescription, or get added to farm animals just in case, speed up that march toward resistance.
Folks can’t shake off these threats with home remedies or hope. Hospitals guard effective antibiotics like amikacin fiercely because the fall-back options keep shrinking as resistance grows. Any misuse—a half-finished course, sharing pills, taking antibiotics for viruses—gives bacteria one more shot at figuring out how to defeat medical science.
Better stewardship—smart, cautious prescribing—keeps medicines like amikacin on the table for those who truly need them. It means clear protocols, rapid lab tests, and honest communication between health workers and patients. On my own visits to clinics and emergency rooms, I’ve watched doctors double-check records to avoid unnecessary antibiotic orders.
Adding to that, public education holds just as much power. People who understand why antibiotics are precious rarely demand them for sniffles. Hospitals that review every high-risk prescription help ensure that future generations won’t face untreatable infections.
Amikacin sulfate doesn’t show up for routine cases—it forms the last line of defense once easy answers fail. Resistance trends only grow more alarming over time. Everyone—doctors, pharmacists, patients—shares responsibility for using these lifesaving drugs wisely. Amikacin offers one more round in the fight against the world’s toughest germs, but the window for action keeps narrowing.
Amikacin Sulfate has played a key role on hospital floors and in clinics for years. People going through tough infections—think serious ones caused by bacteria that ordinary antibiotics can’t touch—rely on it. The way it’s delivered stands out. Amikacin isn’t swallowed as a pill or sipped from a spoon. Doctors and nurses reach for vials, syringes, and infusion pumps to get it where it needs to go. That’s because the gut can’t absorb it right. Try giving it by mouth, and it just won’t work.
I remember working with a group of infection specialists who saw one patient after another fighting kidney infections that didn’t budge with basic drugs. Amikacin came into play, in shots and drips. Most patients either got it injected directly into muscle—think thigh or upper arm—or through a vein. Both options move the drug right into the bloodstream, bypassing the digestive system altogether. IV (intravenous) delivery gets used for really sick folks because the medicine hits the body fast. IM (intramuscular) shots come up as a plan B, sometimes in places where veins are tough to find or equipment is limited.
Giving amikacin isn’t as simple as giving a vitamin shot. Dosing depends on weight, kidney function, and age. Some folks process the drug slowly, so giving the same shot to a young, healthy person and an older, frailer one could cause problems. Those adjustments happen in real time. Doctors lean into decades of data here: too low a dose, and tough bacteria win; too high a dose, and kidneys and hearing can take a hit. Frequent blood draws confirm drug levels—these “peak” and “trough” values steer the care team’s choices.
Many antibiotics don’t require close watching. Amikacin does. It’s a heavy hitter, useful against stubborn bugs, but it packs risks. Nurses and pharmacists check kidney numbers more often for anyone getting the drug. Tinnitus and hearing changes get reported, too, since the drug can harm hearing if not managed carefully. It’s a classic lesson in medicine: the best tools ask for skill and caution.
I remember rural clinics that didn’t have infusion pumps or much lab access. Nurses in those settings worked with what they had: drawing up careful doses and using their best skills to judge veins. When resources fall short, keeping patients safe gets harder. Some clinics find ways to partner with city hospitals—sending samples out for drug level checks or even borrowing an infusion pump for critical cases. These workarounds aren’t perfect, but they show how health care workers step up, even without fancy technology.
Hospitals now use electronic medication records to flag high-risk patients. Automated dose calculators, based on real patient data, cut down on dosing mistakes. Point-of-care testing devices for blood levels start to become more common, and training sessions help new nurses spot the warning signs of kidney or ear trouble early on. These steps don’t just help doctors—they help everybody who depends on antibiotics to bounce back from serious illness.
The way Amikacin Sulfate gets into the body isn’t a side detail—it affects recovery, safety, and even who gets well. Giving it right takes experience, teamwork, and attention, because antibiotics like this still save lives, one drip or shot at a time.
Amikacin sulfate steps onto the scene as a big gun among antibiotics, tackling tough infections that don’t budge easily. In hospitals, doctors reserve it for serious cases like complicated urinary tract infections, pneumonia, and certain stubborn gram-negative infections. My own time in hospital wards has shown me just how carefully teams monitor patients who get amikacin therapy. You just can’t shrug off this medication. Its power comes with real concerns, and protecting patients starts with honest, clear talk about side effects.
Two side effects dominate every conversation about amikacin: hearing loss and kidney damage. Research keeps pointing to these issues, especially after regular doses over a few days or weeks. Many people taking amikacin develop some ringing in the ears or notice hearing changes. This isn’t about distant statistics. I’ve met patients, or their families, reporting muffled sounds and even stronger symptoms after a course of treatment. Several studies estimate that between 10% and 25% of patients on aminoglycoside antibiotics notice some hearing issues, even if temporary.
Kidney function always comes under threat as well. In my experience, lab checks happen every few days. One shift, I watched a patient’s creatinine jump after five days of treatment; it meant the doctor needed to switch drugs fast. Evidence from journals backs up this approach—monitoring kidney markers takes shape as a must, not a maybe. Many healthcare teams use the lowest effective dose and keep therapy short, a direct response to the risks that have shown up for decades in both research and real life.
On top of ears and kidneys, people sometimes feel numbness, experience muscle twitching, or even struggle to control movements. Nerve trouble doesn’t show up as often, but it adds another layer of risk, especially for folks already facing nerve issues. Sometimes headaches, rash, nausea, and fever pop up. These problems rarely demand a hospital stay alone, but taken together, they add stress and can disrupt other treatments in the hospital.
Kids, older adults, and people already dealing with hearing or kidney problems walk into amikacin therapy with more risk. Dehydration can make everything worse. Doctors and nurses pay extra attention to people who’ve taken similar drugs before, since damage from one course can add up in future rounds. I’ve seen doctors hold tough conversations with parents of young patients, explaining why even the smallest sign—trouble hearing, changes in urine—should push someone to speak up immediately.
Keeping doses on the lower end, using drug levels from blood samples, stopping treatment once the infection clears—these actions help control risk. Education stands out as the strongest tool. Explaining what side effects to look out for lets patients act fast. Drug companies and hospitals now supply detailed leaflets, but one-on-one conversation leaves more impact.
Balancing life-saving strength with safety means more than talking risks; it means building care plans based on what we already know and always listening to what patients notice in their own bodies.
Amikacin Sulfate can clear tough infections when other antibiotics fail. Doctors trust it against stubborn bacteria, but that power comes with real risks. Having watched friends take strong antibiotics, the pattern is clear: These medicines are not for casual use. Amikacin belongs on that list. Taking shortcuts increases the danger, especially for kidneys and hearing.
A doctor’s office once taught me that what’s “safe” for one person isn’t safe for everyone. If a patient has kidney trouble, Amikacin can turn a kidney scare into permanent damage. Pre-existing hearing issues make matters worse: hearing loss connected to Amikacin doesn’t always reverse. My own family history made me double-check medications, especially after learning a cousin faced hearing loss after using a similar antibiotic. The lesson stuck. Always mention kidney or ear problems during the first conversation about this drug.
No antibiotic sits isolated from other drugs. Regular medication for arthritis or water retention often interacts with Amikacin. Some pain relievers, like ibuprofen, raise kidney stress. Another group, called diuretics, can intensify hearing risks. Bringing a current medicine list, including supplements, to every appointment goes a long way. Every pharmacist I’ve known has stories of people harmed by mixing medicines. Accuracy on that list isn’t just bureaucratic—it’s essential.
Doctors rely on blood and urine tests before starting Amikacin. These tests check if kidneys can handle the strain and catch unseen problems. In my work in a clinic, folks often skipped labs to save time, only to end up with complications later. Results can guide the right dose and duration. Dosing isn’t guesswork; it depends on age, weight, and the latest test numbers. Expect repeat tests during and after treatment. It’s not extra—each test lowers the odds of long-term trouble.
Hospital teams usually give Amikacin as an injection or IV drip, not by mouth. Home use means learning how to prepare, inject, and watch for warning signs. It’s easy to miss something—sometimes swelling, sometimes changes in urine. Sharp dizziness or hearing changes mean stopping the medicine and calling for help. Nurses have shared more than once how early action spared someone from lifelong hearing loss. Having a support system helps, especially for folks managing complicated schedules or vision issues.
Children, pregnant women, and older adults often face higher risk with these antibiotics. The developing hearing system in kids can suffer damage, so doctors think twice before prescribing. Pregnant patients—especially in the first trimester—should weigh the benefits against real, established risks. In seniors, slower kidney function means doses need adjustment. That’s not just formal advice; it’s based on lived experience from those who faced complications simply because no one asked the right questions.
Before starting Amikacin Sulfate, every patient deserves real answers. It’s tempting to breeze through consent forms or skip details, but those forms exist for good reason. Involving family or trusted caregivers in discussions can prevent missteps. Open communication with the care team makes a difference. Each person’s story—good or bad—builds collective knowledge. The stakes are high, but informed, honest dialogue protects health and helps Amikacin do what it’s meant to do: save lives, not complicate them.
Pregnancy and breastfeeding both bring new worries. Medications that seem routine at other times now raise alarms, and for good reason. Amikacin sulfate, a powerful antibiotic from the aminoglycoside family, comes under special scrutiny. Doctors have relied on it for stubborn infections, especially those resistant to other drugs. But when a mother or her baby enters the picture, the stakes climb. I’ve seen families weigh treatment options as if standing at a fork in the road, uncertain and nervous, not wanting to harm the new life they're nurturing.
According to the U.S. Food and Drug Administration, amikacin falls under Category D for pregnancy. This means clear evidence shows risk to the baby, but in some cases the benefits outweigh the danger. Science shows that amikacin can cross the placenta. Animal studies and reports in humans have linked it to hearing loss and kidney problems in babies exposed during pregnancy. Most doctors choose other antibiotics whenever a safer option exists. They only reach for amikacin if nothing else will do, like in life-threatening infections that ignore gentler drugs.
During breastfeeding, the math changes a little. Amikacin does appear in breast milk, but only in small amounts—not enough to cause side effects in most babies. The doctor must still check each case closely. If a mom has to take amikacin, they’ll usually tell her to watch her baby for symptoms such as diarrhea, diaper rash, or unusual fussiness. The milk itself won’t deliver a dangerous dose, but extra caution makes sense around premature infants or those with kidney problems.
I remember a friend from my college days who developed a severe kidney infection right after giving birth. Her antibiotic options quickly thinned out because so many bacteria had learned to outsmart older drugs. Doctors finally turned to amikacin, monitoring her and the new baby around the clock. They weighed risk and reward constantly, taking extra blood tests and adjusting doses with care. Her story turned out well. Her infection cleared, she continued breastfeeding with support, and the medical team caught small issues fast, before they could grow.
Parents deserve clear, honest information about drugs like amikacin. Better communication can lower stress during tough moments. Hospitals should support shared decision-making for moms who need antibiotics, connecting them with pharmacists, social workers and pediatricians. New antibiotic research also deserves more funding. We need treatments that don’t just wipe out bacteria, but also protect the next generation. Here, investment in maternal child health studies pays back for families everywhere.
For now, amikacin in pregnancy or breastfeeding stays as a last resort—never a first choice. If the only other option risks a mother’s life, careful use backed by close monitoring becomes the path forward. Medical teams still need to consider all factors: the mother's health, the infection's seriousness, and the baby's well-being. In my experience, these decisions work best with trust, teamwork, and open lines of communication between mothers and their care providers.
| Names | |
| Preferred IUPAC name | (2S)-4-amino-2-hydroxy-N-[(1R,2S,3S,4S,6R)-4-amino-3-[(2R,3R,4R,5S)-4-amino-3-hydroxy-5-(hydroxymethyl)-6-methyloxan-2-yl]oxy-2-hydroxy-6-methylamino-5-oxo-2,3,4,5-tetrahydro-1H-pyran-6-yl]-butanamide sulfate |
| Other names |
Amikacin Amikin Amikacinum Amikacina Amikacine Kanamycin A sulfate |
| Pronunciation | /ˌæm.ɪˈkeɪ.sɪn ˈsʌl.feɪt/ |
| Preferred IUPAC name | (2S)-3-Amino-6-\{[(1R,2S,3R,4S,6R)-4-amino-3-[(2S,3R,4S,6S)-3-amino-6-(aminomethyl)-4-hydroxy-2-methoxyoxan-2-yl]oxy-2-hydroxy-6-methyloxan-1-yl]amino\}-2-hydroxy-N-[(1S)-4-amino-2-hydroxy-1-(hydroxymethyl)butan-2-yl]-2-methylhexanamide sulfate |
| Other names |
Amikacin Amikacinum Amikacina Amikacine Biklin Amikin |
| Pronunciation | /ˌæm.ɪˈkeɪ.sɪn ˈsʌl.feɪt/ |
| Identifiers | |
| CAS Number | 39831-55-5 |
| Beilstein Reference | 3686686 |
| ChEBI | CHEBI:31797 |
| ChEMBL | CHEMBL1201118 |
| ChemSpider | 21476702 |
| DrugBank | DB00479 |
| ECHA InfoCard | EC Number 242-646-8 |
| EC Number | 205-348-8 |
| Gmelin Reference | 88248 |
| KEGG | C06848 |
| MeSH | D000593 |
| PubChem CID | 441375 |
| RTECS number | AR2975000 |
| UNII | JJ638V9TTT |
| UN number | UN2811 |
| CAS Number | 39831-55-5 |
| Beilstein Reference | 3918447 |
| ChEBI | CHEBI:32441 |
| ChEMBL | CHEMBL451 |
| ChemSpider | 19833260 |
| DrugBank | DB00479 |
| ECHA InfoCard | 14e47eaf-6cf2-406b-b947-6ccf13d36e4b |
| EC Number | 205-308-5 |
| Gmelin Reference | 28538 |
| KEGG | D02650 |
| MeSH | D000602 |
| PubChem CID | 441370 |
| RTECS number | **UF8305000** |
| UNII | 19X32620CK |
| UN number | UN3249 |
| Properties | |
| Chemical formula | (C22H43N5O13)2·H2SO4 |
| Molar mass | 781.0 g/mol |
| Appearance | A white to off-white, crystalline powder |
| Odor | Odorless |
| Density | Density: 1.225 g/cm³ |
| Solubility in water | Freely soluble in water |
| log P | -6.4 |
| Acidity (pKa) | Acidity (pKa): 7.2 |
| Basicity (pKb) | 8.6 |
| Magnetic susceptibility (χ) | −7.6 × 10⁻⁶ |
| Dipole moment | 2.55 D |
| Chemical formula | C22H43N5O13·2H2SO4 |
| Molar mass | 585.6 g/mol |
| Appearance | White to off-white crystalline powder |
| Odor | Odorless |
| Density | 1.124 g/cm3 |
| Solubility in water | Freely soluble in water |
| log P | -8.6 |
| Acidity (pKa) | 7.1 |
| Basicity (pKb) | 8.8 |
| Magnetic susceptibility (χ) | -9.6 × 10⁻⁶ cm³/mol |
| Dipole moment | 2.73 D |
| Thermochemistry | |
| Std molar entropy (S⦵298) | 364.8 J·mol⁻¹·K⁻¹ |
| Pharmacology | |
| ATC code | J01GB06 |
| ATC code | J01GB06 |
| Hazards | |
| Main hazards | May cause allergic reactions, nephrotoxicity, ototoxicity, respiratory paralysis, and irritation to skin, eyes, and respiratory tract. |
| GHS labelling | GHS07, GHS08 |
| Pictograms | GHS05,GHS07 |
| Signal word | Warning |
| Hazard statements | Hazard statements: May cause allergic skin reaction. May cause respiratory irritation. |
| Precautionary statements | Keep out of reach of children. |
| Lethal dose or concentration | LD50 (mouse, IV): 2 g/kg |
| LD50 (median dose) | LD50 (median dose): 2.0 g/kg (intravenous, mouse) |
| PEL (Permissible) | 100 µg/m³ |
| REL (Recommended) | 15 mg/kg/day IM/IV in 2-3 divided doses |
| IDLH (Immediate danger) | No IDLH established. |
| Main hazards | May cause allergic reactions, nephrotoxicity, ototoxicity, and respiratory paralysis. |
| GHS labelling | GHS05, GHS07 |
| Pictograms | GHS05,GHS07,GHS08 |
| Signal word | Warning |
| Hazard statements | No hazard statements. |
| Precautionary statements | Keep out of reach of children. For intramuscular or intravenous use only. Use only as directed by a physician. Discontinue use if hypersensitivity or adverse reactions occur. Avoid contact with eyes, skin, and clothing. Store in a cool, dry place. |
| NFPA 704 (fire diamond) | 1-3-1 |
| Lethal dose or concentration | LD50 (mouse, intravenous): 1,210 mg/kg |
| LD50 (median dose) | LD50 (median dose): Mouse (IV): 400 mg/kg |
| PEL (Permissible) | 100 µg/m³ |
| REL (Recommended) | 15 mg/kg/day IM/IV in 2-3 divided doses |
| IDLH (Immediate danger) | Not Listed |
| Related compounds | |
| Related compounds |
Gentamicin Tobramycin Kanamycin Neomycin Streptomycin Netilmicin Sisomicin Paromomycin |
| Related compounds |
Kanamycin Gentamicin Tobramycin Neomycin Streptomycin Netilmicin Sisomicin |
