Tags

Type your tag names separated by a space and hit enter

Stability of Antibiotics for Intraperitoneal Administration in Extraneal 7.5% Icodextrin Peritoneal Dialysis Bags (STAB Study).
Perit Dial Int 2016 Jul-Aug; 36(4):421-6PD

Abstract

BACKGROUND AND OBJECTIVES

Patients with peritoneal dialysis (PD)-associated peritonitis may be advised to store PD-bags with pre-mixed antibiotics at home, although there is a paucity of antibiotic stability studies in the commonly used icodextrin solutions. The purpose of this study was to assess the stability of various antibiotics in PD-bags when stored at different temperatures over a 14-day period. ♦

METHODS

7.5% icodextrin PD-bags were dosed with gentamicin 20 mg/L (n = 9), vancomycin 1,000 mg/L (n = 9), cefazolin 500 mg/L (n = 9) and ceftazidime 500 mg/L (n = 9) as for intermittent dosing. Combinations of gentamicin/vancomycin (n = 9), cefazolin/ceftazidime (n = 9), and cefazolin/gentamicin (n = 9) were also tested. Nine drug-free bags were used as controls. Bags were stored in triplicate at 37°C, room-temperature (25°C), and refrigeration (4°C). Antibiotic concentrations were quantified at various time intervals using validated chromatography. Storage duration was considered unstable if the concentration of the antibiotic dropped ≤ 90% of the initial value. ♦

RESULTS

Gentamicin was stable for 14 days at all temperatures. Vancomycin was stable for 4 days at 37°C and for 14 days at both 25°C and 4°C. The gentamicin and vancomycin combination was stable for 4 days at 37°C and for 14 days at 25°C and 4°C. Cefazolin alone was stable for 24 hours at 37°C, 7 days at 25°C, and 14 days at 4°C. Ceftazidime alone was stable for only 6 hours at 37°C, 2 days at 25°C, and 14 days at 4°C. The cefazolin and ceftazidime combination was stable for 24 hours at 37°C, 2 days at 25°C, and 14 days at 4°C. The cefazolin and gentamicin combination was stable for 1 day at 37°C, 4 days at 25°C, and 14 days at 4°C. ♦

CONCLUSIONS

Antibiotics premixed in icodextrin PD-bags have varying stabilities with stability generally least at 37°C and best at 4(o)C, permitting storage for 14 days when refrigerated and prewarming to body temperature prior to administration. Further research confirming the sterility of these antibiotic-containing bags is recommended.

Authors+Show Affiliations

Department of Renal Medicine, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia dwarakanathan.ranganathan@health.qld.gov.au.Burns, Trauma & Critical Care Research Centre, The University of Queensland, Herston, Brisbane, Queensland, Australia.Burns, Trauma & Critical Care Research Centre, The University of Queensland, Herston, Brisbane, Queensland, Australia.Burns, Trauma & Critical Care Research Centre, The University of Queensland, Herston, Brisbane, Queensland, Australia Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia.Department of Renal Medicine, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia.Burns, Trauma & Critical Care Research Centre, The University of Queensland, Herston, Brisbane, Queensland, Australia Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia Pharmacy Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26493753

Citation

Ranganathan, Dwarakanathan, et al. "Stability of Antibiotics for Intraperitoneal Administration in Extraneal 7.5% Icodextrin Peritoneal Dialysis Bags (STAB Study)." Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, vol. 36, no. 4, 2016, pp. 421-6.
Ranganathan D, Naicker S, Wallis SC, et al. Stability of Antibiotics for Intraperitoneal Administration in Extraneal 7.5% Icodextrin Peritoneal Dialysis Bags (STAB Study). Perit Dial Int. 2016;36(4):421-6.
Ranganathan, D., Naicker, S., Wallis, S. C., Lipman, J., Ratanjee, S. K., & Roberts, J. A. (2016). Stability of Antibiotics for Intraperitoneal Administration in Extraneal 7.5% Icodextrin Peritoneal Dialysis Bags (STAB Study). Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, 36(4), pp. 421-6. doi:10.3747/pdi.2015.00062.
Ranganathan D, et al. Stability of Antibiotics for Intraperitoneal Administration in Extraneal 7.5% Icodextrin Peritoneal Dialysis Bags (STAB Study). Perit Dial Int. 2016;36(4):421-6. PubMed PMID: 26493753.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stability of Antibiotics for Intraperitoneal Administration in Extraneal 7.5% Icodextrin Peritoneal Dialysis Bags (STAB Study). AU - Ranganathan,Dwarakanathan, AU - Naicker,Saiyuri, AU - Wallis,Steven C, AU - Lipman,Jeffrey, AU - Ratanjee,Sharad K, AU - Roberts,Jason A, Y1 - 2015/10/22/ PY - 2015/03/09/received PY - 2015/05/25/accepted PY - 2015/10/24/entrez PY - 2015/10/24/pubmed PY - 2017/3/17/medline KW - Cefazolin KW - ceftazidime KW - gentamicin KW - peritonitis KW - stability KW - vancomycin SP - 421 EP - 6 JF - Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis JO - Perit Dial Int VL - 36 IS - 4 N2 - UNLABELLED: ♦ BACKGROUND AND OBJECTIVES: Patients with peritoneal dialysis (PD)-associated peritonitis may be advised to store PD-bags with pre-mixed antibiotics at home, although there is a paucity of antibiotic stability studies in the commonly used icodextrin solutions. The purpose of this study was to assess the stability of various antibiotics in PD-bags when stored at different temperatures over a 14-day period. ♦ METHODS: 7.5% icodextrin PD-bags were dosed with gentamicin 20 mg/L (n = 9), vancomycin 1,000 mg/L (n = 9), cefazolin 500 mg/L (n = 9) and ceftazidime 500 mg/L (n = 9) as for intermittent dosing. Combinations of gentamicin/vancomycin (n = 9), cefazolin/ceftazidime (n = 9), and cefazolin/gentamicin (n = 9) were also tested. Nine drug-free bags were used as controls. Bags were stored in triplicate at 37°C, room-temperature (25°C), and refrigeration (4°C). Antibiotic concentrations were quantified at various time intervals using validated chromatography. Storage duration was considered unstable if the concentration of the antibiotic dropped ≤ 90% of the initial value. ♦ RESULTS: Gentamicin was stable for 14 days at all temperatures. Vancomycin was stable for 4 days at 37°C and for 14 days at both 25°C and 4°C. The gentamicin and vancomycin combination was stable for 4 days at 37°C and for 14 days at 25°C and 4°C. Cefazolin alone was stable for 24 hours at 37°C, 7 days at 25°C, and 14 days at 4°C. Ceftazidime alone was stable for only 6 hours at 37°C, 2 days at 25°C, and 14 days at 4°C. The cefazolin and ceftazidime combination was stable for 24 hours at 37°C, 2 days at 25°C, and 14 days at 4°C. The cefazolin and gentamicin combination was stable for 1 day at 37°C, 4 days at 25°C, and 14 days at 4°C. ♦ CONCLUSIONS: Antibiotics premixed in icodextrin PD-bags have varying stabilities with stability generally least at 37°C and best at 4(o)C, permitting storage for 14 days when refrigerated and prewarming to body temperature prior to administration. Further research confirming the sterility of these antibiotic-containing bags is recommended. SN - 1718-4304 UR - https://www.unboundmedicine.com/medline/citation/26493753/Stability_of_Antibiotics_for_Intraperitoneal_Administration_in_Extraneal_7_5_Icodextrin_Peritoneal_Dialysis_Bags__STAB_Study__ L2 - http://www.pdiconnect.com/cgi/pmidlookup?view=long&pmid=26493753 DB - PRIME DP - Unbound Medicine ER -