Pharmacokinetics of single-dose intravenous amikacin in critically ill patients undergoing slow hemodialysis.

OBJECTIVE

The pharmacokinetics of amikacin were studied in patients undergoing slow hemodialysis (HD).

DESIGN

Slow HD was performed at the dialysate flow rate of 30 ml/min. After a single intravenous dose of amikacin 5 mg/kg, pharmacokinetic variables were calculated by fitting individual concentration-time curves to a two-compartment open model.

PATIENTS

6 critically ill patients with renal failure were entered into the study.

RESULTS

The volume of distribution was 0.35 +/- 0.03 l/kg. Total body clearance was 35.1 +/- 2.3 ml/min with an elimination half-life of 10.5 h. During a 10.5 h session of slow HD, the serum amikacin concentration decreased from the peak level of 21.3 +/- 1.2 mg/l to 7.2 +/- 0.9 mg/l.

CONCLUSION

Slow HD eliminate amikacin more efficiently than other types of slowly performed renal replacement therapy and had profound effects on the pharmacokinetics. Amikacin elimination by this approach should be taken into consideration for designing a dosage schedule during the treatment.