Mikastar 500 Injection is a sterile, pyrogen-free solution of amikacin sulfate, a broad-spectrum antibiotic, available in a 2 mL ampoule. The product is indicated for the treatment of Gram-negative infections, including pneumonia, septicemia, and urinary tract infections. Amikacin, the active ingredient, inhibits protein synthesis by binding to the 30S ribosomal subunit, thereby disrupting bacterial protein synthesis. Mikastar 500 Injection is administered intramuscularly or intravenously every 12 hours. The usual dose for adults and pediatric patients is 15 mg/kg, not exceeding 1 g, per day. The duration of therapy should be guided by clinical response and susceptibility testing. Common adverse reactions include vestibular disturbances, tinnitus, and nephrotoxicity. Patients with pre-existing kidney disease or receiving concomitant nephrotoxic medications are at increased risk of developing nephrotoxicity. Monitoring of renal function and audiological evaluations are recommended during therapy. Mikastar 500 Injection should be used with caution in patients with known or suspected hearing impairment.