Recent information suggests that single, large daily dosages of amikacin are less nephrotoxic. The killing rate of amikacin for Escherichia coli and Pseudomonas aeruginosa also suggests to put emphasis on a high peak value. A decrease of 3 log10 CFU/ml was observed for E. coli and P. aeruginosa at 64 and 128 micrograms/ml in 20 min. In comparison, the killing rate of piperacillin was dose-independent and about 6 h were required for a reduction of 10(3) CFU/ml of P. aeruginosa. In theory, the way to proceed in the future would possibly be the one-shot administration of amikacin, followed by a long course of a beta-lactam antibiotic.
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Yourassowsky et al. (2009) studied this question.