In this report we present the history of a patient treated with
continuous ambulatory peritoneal dialysis (
CAPD) in whom episodes of
hypotonia can be related to the administration of
amikacin, an
antibiotic from the
aminoglycosides group. The 68-year-old female patient was admitted for initiation of
renal replacement therapy with
CAPD. Her
renal failure was probably attributable to
hypertension. Three days after
catheter implantation, the patient reported dysuric symptoms, and a urine culture showed significant growth of Escherichia coli.
Amikacin 250 mg and
cefazolin 1.0 g were administered intravenously once daily in accordance with the antibiogram. On the third day of
antibiotic administration, the patient fainted, showing an arterial blood pressure of 90/60 mmHg. On the subsequent 2 days, decreases of postural arterial blood pressure to between 90/60 mmHg and 80/50 mmHg were reported two or three times daily. The patient was treated with
antibiotics for the next 6 days and felt very bad the entire time, with an arterial blood pressure of 80/50 mmHg. The patient's condition improved 2 days after discontinuation of treatment with
antibiotics, and episodes of
hypotonia stopped. The decrease in the arterial blood pressure observed in our patient during
intravenous administration of
amikacin can, with a high probability, be related to the calcimimetic activity of this
aminoglycoside and the resulting inhibition of parathyroid secretion.