Amikacin is an aminoglycoside antibiotic that inhibits bacterial protein synthesis. Amikacin binds irreversibly to the bacterial 30S ribosomal subunit protein and 16S rRNA and prevents the formation of the initiation complex with messenger RNA. More specifically, amikacin binds four nucleotides of the 16S rRNA and a single amino acid of protein S12. This interferes with the decoding site in the vicinity of nucleotide 1400 in 16S rRNA of the 30S subunit. This region interacts with the wobble base of the anticodon of tRNA. This leads to interference with the initiation complex, misreading of mRNA so that incorrect amino acids are inserted into the polypeptide leading to nonfunctional or toxic peptides, and the breakup of polysomes into nonfunctional monosomes. Aminoglycosides are useful in treating infections from mycobacteria such as, tuberculosis, and aerobic Gram-negative bacteria including, Pseudomonas, Acinetobacter and Enterobacter. Aminoglycosides can also treat Gram-positive bacterial infections but are inferior to other available antibiotics. Aminoglycosides may be used in combination with penicillin type antibiotics. Aminoglycosides are not an effective treatment for anaerobic bacteria, fungi and viruses.

Amikacin Pathway References