Lack of lung tissue and systemic accumulation after consecutive daily aerosols of amikacin in ventilated piglets with healthy lungs.

IN a model of ventilated piglets with healthy lungs, we recently demonstrated a substantial deposition of nebulized amikacin into the distal lung. However, only half of the amount of amikacin available for the lungs was eliminated in the urine; the other half was either fixed in the lungs, eliminated by mucociliary clearance, or distributed in other organs. Consequently, consecutive daily nebulizations of amikacin may result in lung tissue accumulation and systemic accumulation, and the frequency of readministration should be defined in experimental animals before nebulized amikacin can be safely used in humans for treating or preventing ventilatorassociated pneumonia. The aim of the present study was to assess lung tissue and plasma pharmacokinetics resulting from the daily nebulization of amikacin during a 4-day period of mechanical ventilation in anesthetized piglets with healthy lungs.