Elimination and penetration of amikacin into urine in patients with decreased glomerular filtration rate

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F24%3A10474434" target="_blank" >RIV/00064165:_____/24:10474434 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/24:10474434 RIV/00064203:_____/24:10474434

Result on the web

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=Dr8yCCo8A" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=Dr8yCCo8A</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/ckj/sfae002" target="_blank" >10.1093/ckj/sfae002</a>

Result language

angličtina

Original language name

Elimination and penetration of amikacin into urine in patients with decreased glomerular filtration rate

Original language description

BACKGROUND: Amikacin monotherapy is recommended for urinary tract infection (UTI) treatment with multi-resistant pathogens. Even though amikacin efficacy in the treatment of UTIs is dependent on its urinary concentration, there are no robust data proving that sufficiently high urinary concentration is reached in patients with reduced glomerular filtration rate (GFR). METHODS: A prospective study to monitor amikacin penetration into urine of 70 patients [40 males, median (interquartile range) age 70 (65-79) years] with different levels of glomerular filtration decline, including patients treated by dialysis, was conducted. The bactericidal efficacy of amikacin in urine samples has been evaluated. RESULTS: Patients with estimated GFR (eGFR) &lt;30 mL/min had significantly lower median amikacin urinary concentration than patients with eGFR &gt;30 mL/min (89.75 vs 186.0 mg/L, P &lt; .0001; 200.5 vs 830.0 mg/L, P &lt; .0001; and 126.0 vs 408.0 mg/L, P &lt; .0001 for minimal, maximal and minimal together with maximal concentrations, respectively). The amount of amikacin eliminated in the first 10-13 h after dose administration was dependent on eGFR (r(2) = 0.6144, P &lt; .0001). The urinary concentration of amikacin in patients treated by dialysis was indirectly proportional to pH of urine. The plasma concentrations of amikacin did not correlate with urinary levels in patients in either of the GFR categories. Microbiological evaluation showed that the critical urinary concentration for efficacy of amikacin during UTI monotherapy in patients treated by dialysis is 100 mg/L. We found that 4 out of 11 patients treated by dialysis did not reach this level during the treatment. CONCLUSION: Systemic administration of amikacin monotherapy in patients treated by dialysis is questionable as the concentrations of amikacin in their urine are often below the threshold of effectivity. Amikacin plasma concentrations are not a major determinant of amikacin concentration in urine, therefore pulse dosing is neither necessary nor safe in patients treated by dialysis, and may cause undesirable toxicity.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30217 - Urology and nephrology

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Clinical Kidney Journal

ISSN

2048-8505

e-ISSN

2048-8513

Volume of the periodical

17

Issue of the periodical within the volume

1

Country of publishing house

GB - UNITED KINGDOM

Number of pages

10

Pages from-to

sfae002

UT code for WoS article

001150519500002

EID of the result in the Scopus database

2-s2.0-85183744372