Amikacin – treatment of an urinary tract infection in a hemodialysis patient – what may be eventualy missed?

Hippokratia 2006, 10(1):39-40

D Yonova, E Vazelov, V Papazov, I Trendafilov, A Simeonov
Dialysis Clinic, Medical University Hospital “Alexandrovska”, Sofia, Bulgaria


The study is presenting a clinical case of a diabetic patient on regular haemodialysis treatment with an exacerbated urinary infection, demonstrated by fever, microhematuria, disuria and significant bacteriuria. The urinary bacterial infection (Pseudomonas aeruginosa >10 5 , sensitive to amikacin) was treated ineffectively by an aminoglucoside (amikacin) until pH of the urine was changed to slight alkaline level – the appropriate media in which aminoglucosides are effective and reasonably applied. The successful treatment after alkalization proved that pH of the media is of great mportance for aminoglucoside’s therapy and must not be neglected.