Hemodialysis of amikacin in critically ill patients.

The clearance of amikacin during hemodialysis (HD) was determined in eight critically ill patients. The dialysis period averaged 3.4 h with a blood flow of 200 ml/min. The average amikacin clearance between dialysis was 7.30 +/- 4.78 (SD) ml/min which increased to 37.5 +/- 8.01 ml/min during dialysis. The average serum amikacin concentration before dialysis fell 27% after dialysis. The fraction of drug in the body removed only from dialysis averaged 21%. Although amikacin was cleared more effectively during HD compared to the interdialysis period, the small amount of drug removed suggests that routine supplemental dosing of amikacin after HD may not be necessary.