Amikacin levels in the human biliary tract

Area of Science:

• Pharmacology
• Surgical Research
• Clinical Therapeutics

Background:

• Amikacin is an aminoglycoside antibiotic used for serious bacterial infections.
• Understanding amikacin distribution in biliary tract tissues and fluids is crucial for optimizing treatment efficacy and safety.
• Biliary tract surgery patients present a unique population for pharmacokinetic studies.

Purpose of the Study:

• To investigate amikacin concentrations in serum, gallbladder, common duct bile, and gallbladder tissue.
• To evaluate amikacin pharmacokinetics in patients undergoing biliary tract surgery.
• To assess the safety profile of amikacin in this patient cohort.

Main Methods:

• Patients received 500 mg of amikacin intravenously or intramuscularly prior to surgery.
• Serum, bile, and tissue samples were collected at various time points (0.5, 6, and 11 hours post-administration).
• Serial postoperative measurements were performed in patients with T-tubes.

Main Results:

• Amikacin serum levels were high 0.5 hours post-administration, with bile levels at 30% and tissue levels <19% of serum levels.
• At 6 hours, bile levels were 34% of simultaneous serum levels.
• At 11 hours, although both serum and bile amikacin levels were low, bile levels exceeded serum levels. No adverse effects were reported.

Conclusions:

• Amikacin achieves measurable concentrations in the biliary system, with a delayed but potentially significant presence in bile relative to serum.
• The pharmacokinetic profile suggests amikacin may be beneficial in treating infections within the biliary tract.
• Amikacin demonstrated a favorable safety profile in patients undergoing biliary tract surgery.