Hemodialysis of amikacin in critically ill patients

Armstrong, Deborah K.; Hodgman, Tudy; Visconti, James A.; Reilley, Thomas E.; Garner, W.L.; Dasta, Joseph F.

doi:10.1097/00003246-198805000-00010

Cited by 13 publications

(2 citation statements)

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“…In eight critically ill patients, amikacin clearance increased from 7.3 ± 4.8 mL/min to 37.5 ± 8.1 mL/min during dialysis [22]. In six ICU patients treated with slow haemodialysis, total CL was calculated at 35 mL/min with an elimination t 1/2 of 10.5 h [23].…”

mentioning

confidence: 99%

Pharmacokinetics of a loading dose of amikacin in septic patients undergoing continuous renal replacement therapy

Taccone¹,

Backer²,

Laterre³

et al. 2011

International Journal of Antimicrobial Agents

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mentioning

confidence: 99%

Pharmacokinetics of a loading dose of amikacin in septic patients undergoing continuous renal replacement therapy

Taccone¹,

Backer²,

Laterre³

et al. 2011

International Journal of Antimicrobial Agents

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“…Continuous hemodiafiltration gave an amikacin clearance of 40 mL/min or around 89% of the mean total body clearance [22]; intermittent hemodialysis gave a clearance of 37.5 mL/min amikacin, approximately 21% of total clearance (for hemodialysis sessions of 3 to 4 hours) [23]. In the current study, the clearance of amikacin related to hemodialysis was very close to values found in the literature: clearance of 35.6 mL/min or 14% of total clearance for sessions of 4 h. The hydrophilic nature of amikacin and its low protein binding fraction make possible removal with renal replacement therapy by diffusion, convection and adsorption on the membranes of the artificial kidney [22][23][24]. Few studies exist regarding the removal of amikacin by different renal replacement therapy so it is difficult to determine which technique is the most effective.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of haemodialysis as a protective technique for preventing high daily dose amikacin nephrotoxicity: an experimental study in an ovine model

Pouzot‐Nevoret

Magnin

Ayoub

et al. 2017

International Journal of Antimicrobial Agents

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Changes in pharmacokinetic parameters of critically ill patients make the treatment of infections challenging, particularly when multidrug-resistant bacteria are involved. The aim of this study was to evaluate the ability of haemodialysis to reduce the exposure to high dose amikacin and prevent nephrotoxicity. Amikacin 50 mg/kg was administered intravenously to six adult sheep once-daily for four days. The sheep were divided into two groups according to the implementation (group 1) or not (group 2) of haemodialysis. In group 1, haemodialysis was performed for 4 h, initiated 2 h after starting amikacin infusion. Amikacin area under the curve (AUC) and trough concentrations (C) were used as markers of amikacin-induced nephrotoxicity. The median haemodialysis amikacin clearance was 2.14 L/h (35.6 mL/min), 14% of the mean total body clearance for 24 h. Haemodialysis reduced C (group 1: 0.3 µg/mL [0.3-1.1]; group 2: 1.4 µg/mL [1.1-3.9]; P = 0.0003). A trend towards reduced AUC with haemodialysis was observed (group 1: 1450 µg/mL⋅h [1311-1716]; group 2: 3126 µg/mL⋅h [2581-3171]; P = 0.10). In conclusion, haemodialysis seems interesting in reducing AUC and C after the injection of high-dose of amikacin, parameters known to be involved in its induced nephrotoxicity, in an experimental ovine model.

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