Amikacin therapy of serious gram-negative bacillary infections in chronic hemodialysis patients.

Amikacin was used to treat 7 serious gram-negative bacillary infections in patients undergoing chronic hemodialysis. 4 were caused by pathogens resistant to gentamicin. 5 infections were cured; 1 was improved and another failed to respond. Mean 1-hour peak serum levels of amikacin ranged from 25.8 to 44.3 microgram/ml. Mean serum levels of amikacin after 6 h of hemodialysis were 61.5% of predialysis levels. Amikacin is highly effective but doses must be reduced in patients requiring hemodialysis and serum levels monitored to avoid ototoxicity.