Amikacin offers definite advantages for treating infections caused by organisms resistant to other aminoglycosides. Amikaci is affected by relatively few arninoglycoside-modifying enzymes. Amikacin is useful in the treatment of infections caused by Nocardia asteroides , Mycobacterium avium-intracellulare , and certain species of "rapid-growing" mycobacteria (that is, M. chelonae and M. fortuitumi ).
Amikacin (100-1500 μM) causes a reliable dose-dependent loss of lateral line zebrafish hair cells with a LD ₅₀ value of 453 μM.

Amikacin (320 mg/kg; subcutaneous injection; daily; for 10 days; male Fischer rats) treatment increases the chance of serious hearing loss in rats in vivo.