Pharmacokinetics of amikacin in children undergoing continuous ambulatory peritoneal dialysis

The pharmacokinetics of amikacin were investigated in 3 stable children undergoing continuous ambulatory peritoneal dialysis (CAPD). Each patient was studied after the administration of 2-3 mg/kg amikacin both the intravenous and intraperitoneal routes allowing at least 10 days washout period between doses. After intraperitoneal instillation of amikacin, the antibiotic amikacin appeared in the serum within 15 minutes. The reaction of the intraperitoneal dose absorbed into systemic circulation was found to be between 0.42 to 0.95. When the same dose of amikacin was injected intravenously only a small amount of drug was present in peritoneal fluid for a brief period of a time. Thus, these data suggest that amikacin is absorbed from peritoneal fluid into the circulation, but reverse exchange is negligible. Since instillation of amikacin by intraperitoneal route may allow rapid absorption, periodic control of serum amikacin level is recommended.