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Kanamycin is indicated for short term treatment of bacterial infections caused by one or more of the following pathogens: E. coli, Proteus species (both indole-positive and indole-negative), Enterobacter aerogenes, Klebsiella pneumoniae, Serratia marcescens, and Acinetobacter species. In cases of serious infection when the causative organism is unknown, Kanamycin injection in conjunction with a penicillin- or cephalosporin-type drug may be given initially before obtaining results of susceptibility testing.

Kanamycin does not treat viral infections.

Pregnancy and breast feeding

Kanamycin is pregnancy category D in the United States.

Kanamycin is excreted into breast milk in small amounts. The manufacturer recommends that because of the potential for serious adverse effects in nursing infants, the patient should discontinue nursing or discontinue kanamycin, depending on how important the drug is to the mother. The American Academy of Pediatrics considers kanamycin compatible for breast feeding.

Pediatric use

Kanamycin should be used with caution in neonates due to the risk of increased serum half-life and drug concentration resulting from immature renal function in this patient population.  Mechanism of Action 

Kanamycin works by interfering with protein synthesis. It binds to the 30S subunit of the bacterial ribosome. This results in incorrect alignment with the mRNA and eventually leads to a misread that causes the wrong amino acid to be placed into the peptide. This leads to nonfunctional peptide chains.

Side effects
Serious side effects include tinnitus or loss of hearing, toxicity to kidneys, and allergic reactions to the drug.

Other side effects include:

Gastrointestinal effects Musculoskeletal effects Neurologic effects Metabolic effects
 * Nausea, vomiting, diarrhea
 * Myasthenia gravis
 * Headache
 * Paresthesias
 * Blurring of vision
 * Neuromuscular blockade
 * Malabsorption syndrome

Introduction:
Kanamycin is mainly effective against Gram-negative aerobic bacteria, and has limited activity against many Gram-positive and anaerobic bacteria (3)

Kanamycin is used for short-term treatment only, usually from 7 to 10 days (2). It works by targeting production of important proteins that are essential for bacterial survival (1). However, Kanamycin is not effective in treating colds, flu, or viral infections (2).

Ototoxicity and nephrotoxicity are the most severe adverse effects seen in patients treated with kanamycin, especially in elderly patients (4).

Kanamycin should not be used during pregnancy because the unborn baby could be harmed by the drug. Breastfeeding women should also consult with physician before using kanamycin due to its excretion into breast milk and may cause adverse effects to the infant (4).
 * 1) https://www.drugs.com/cdi/kanamycin.html
 * 2) https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0010823/?report=details
 * 3) http://www.ema.europa.eu/docs/en_GB/document_library/Maximum_Residue_Limits_-_Report/2009/11/WC500014535.pdf
 * 4) https://toxnet.nlm.nih.gov/cgi-bin/sis/search/r?dbs+hsdb:@term+@rn+@rel+59-01-8