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Stability of cefepime in icodextrin peritoneal dialysis solution.
Ann Pharmacother. 2004 Dec; 38(12):2041-4.AP

Abstract

BACKGROUND

Icodextrin is a glucose polymer used as an alternative osmotic agent in peritoneal dialysis (PD) solutions. Cefepime may be a suitable antibiotic for the treatment of PD-related peritonitis. The stability of cefepime in icodextrin PD solution has not been examined.

OBJECTIVE

To determine the chemical stability of cefepime in icodextrin PD solution over a 7-day period.

METHODS

Samples were prepared by adding cefepime HCl 1000 mg to commercially available 2.0-L bags of icodextrin 7.5% PD solution. Nine bags were prepared and stored in the following conditions: 3 under refrigeration (4 degrees C), 3 at room temperature (20 degrees C), and 3 at body temperature (37 degrees C). Study samples were drawn from each bag immediately after preparation and at predetermined intervals over the subsequent 7 days. Solutions were visually inspected for precipitation, cloudiness, or discoloration at each sampling interval. Total concentration of cefepime in dialysate fluid was determined by liquid chromatography-tandem mass spectrometry.

RESULTS

Under refrigeration, a mean +/- SD of 95.7 +/-4.2% of the initial cefepime concentration remained at 168 hours (7 days). At room temperature, 92.0 +/- 17.9% remained at 48 hours. At body temperature, 92.2 +/- 4.7% remained at 4 hours. Beyond these respective time points, <90% of the initial cefepime concentrations remained.

CONCLUSIONS

Pre-mixed cefepime-icodextrin PD solutions stored at room temperature were stable for up to 48 hours. However, it is recommended that these be kept refrigerated whenever possible. When refrigerated, cefepime-icodextrin solutions were found to be stable for up to 7 days. Solutions stored at body temperature were stable up to 4 hours, permitting the practice of pre-warming solutions prior to administration.

Authors+Show Affiliations

Department of Pharmacy Practice, Albany College of Pharmacy, 106 New Scotland Ave., Albany, NY 12208-3492, USA. elwellr@acp.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15494381

Citation

Elwell, Rowland J., et al. "Stability of Cefepime in Icodextrin Peritoneal Dialysis Solution." The Annals of Pharmacotherapy, vol. 38, no. 12, 2004, pp. 2041-4.
Elwell RJ, Volino LR, Frye RF. Stability of cefepime in icodextrin peritoneal dialysis solution. Ann Pharmacother. 2004;38(12):2041-4.
Elwell, R. J., Volino, L. R., & Frye, R. F. (2004). Stability of cefepime in icodextrin peritoneal dialysis solution. The Annals of Pharmacotherapy, 38(12), 2041-4.
Elwell RJ, Volino LR, Frye RF. Stability of Cefepime in Icodextrin Peritoneal Dialysis Solution. Ann Pharmacother. 2004;38(12):2041-4. PubMed PMID: 15494381.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stability of cefepime in icodextrin peritoneal dialysis solution. AU - Elwell,Rowland J, AU - Volino,Lucio R, AU - Frye,Reginald F, Y1 - 2004/10/19/ PY - 2004/10/21/pubmed PY - 2005/2/3/medline PY - 2004/10/21/entrez SP - 2041 EP - 4 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 38 IS - 12 N2 - BACKGROUND: Icodextrin is a glucose polymer used as an alternative osmotic agent in peritoneal dialysis (PD) solutions. Cefepime may be a suitable antibiotic for the treatment of PD-related peritonitis. The stability of cefepime in icodextrin PD solution has not been examined. OBJECTIVE: To determine the chemical stability of cefepime in icodextrin PD solution over a 7-day period. METHODS: Samples were prepared by adding cefepime HCl 1000 mg to commercially available 2.0-L bags of icodextrin 7.5% PD solution. Nine bags were prepared and stored in the following conditions: 3 under refrigeration (4 degrees C), 3 at room temperature (20 degrees C), and 3 at body temperature (37 degrees C). Study samples were drawn from each bag immediately after preparation and at predetermined intervals over the subsequent 7 days. Solutions were visually inspected for precipitation, cloudiness, or discoloration at each sampling interval. Total concentration of cefepime in dialysate fluid was determined by liquid chromatography-tandem mass spectrometry. RESULTS: Under refrigeration, a mean +/- SD of 95.7 +/-4.2% of the initial cefepime concentration remained at 168 hours (7 days). At room temperature, 92.0 +/- 17.9% remained at 48 hours. At body temperature, 92.2 +/- 4.7% remained at 4 hours. Beyond these respective time points, <90% of the initial cefepime concentrations remained. CONCLUSIONS: Pre-mixed cefepime-icodextrin PD solutions stored at room temperature were stable for up to 48 hours. However, it is recommended that these be kept refrigerated whenever possible. When refrigerated, cefepime-icodextrin solutions were found to be stable for up to 7 days. Solutions stored at body temperature were stable up to 4 hours, permitting the practice of pre-warming solutions prior to administration. SN - 1060-0280 UR - https://www.unboundmedicine.com/medline/citation/15494381/Stability_of_cefepime_in_icodextrin_peritoneal_dialysis_solution_ L2 - http://journals.sagepub.com/doi/full/10.1345/aph.1E324?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -