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Stability and Compatibility of Antibiotics in Peritoneal Dialysis Solutions Applied to Automated Peritoneal Dialysis in The Pediatric Population.
Perit Dial Int 2016 11-12; 36(6):676-679PD

Abstract

OBJECTIVES:

Assess the stability of several antibiotics in peritoneal dialysis (PD) solutions under common conditions of use in pediatrics, particularly in automated PD. ♦

METHODS:

Amoxicillin, cefazolin, cefepime, ceftazidime, imipenem, cotrimoxazole, tobramycin, vancomycin, and the association of ceftazidime + vancomycin and ceftazidime + tobramycin, were tested in 3 different PD solutions: bicarbonate/lactate solution with 2 glucose concentrations (Physioneal 1.36 and 3.86%; Baxter Healthcare Corporation, Deerfield, IL, USA) and an icodextrin-containing solution (Extraneal; Baxter Healthcare Corporation, Deerfield, IL, USA). Concentrations were those recommended in guidelines for the treatment of peritonitis in pediatrics. Physioneal bags were incubated at 37°C for 24 hours, whereas Extraneal bags were stored 12 hours at room temperature (22 ± 2°C) and then 12 hours at 37°C. Drug concentrations were determined using high performance liquid chromatography (HPLC). Each measure was taken in triplicate. Stability of antibiotics was defined as less than 10% degradation of the drug over time. ♦

RESULTS:

Cefazolin, cotrimoxazole, tobramycin, and vancomycin were stable under studied conditions. Ceftazidime was stable 24 hours in icodextrin, 12 hours in Physioneal 1.36% and 6 hours in Physioneal 3.86%. The association of tobramycin or vancomycin did not influence the stability of ceftazidime. Cefepime and amoxicillin were stable 6 h, 4 h, and 8 h in Physioneal 1.36%, 3.86% and Extraneal, respectively. The stability of imipenem was very low: 2 h in Physioneal and 6 h in Extraneal. Moreover, an increasingly yellow coloration was observed with the use of imipenem, whereas no color change or precipitation occurred in other bags. ♦

CONCLUSION:

Cefazolin, tobramycin, cotrimoxazole, and vancomycin are stable in PD solutions up to 24 hours and can be administered in the PD bag for the treatment of peritonitis, even in automated PD under studied conditions. However, amoxicillin, cefepime, ceftazidime, and imipenem must be used with caution due to their lack of stability.

Authors+Show Affiliations

Service de Pharmacologie Clinique, CHU de Nantes, France guillaume.deslandes@chu-nantes.fr.Service de Pharmacologie Clinique, CHU de Nantes, France.Service de Pharmacologie Clinique, CHU de Nantes, France.Service de Pharmacologie Clinique, CHU de Nantes, France.Service de Pharmacologie Clinique, CHU de Nantes, France.Service de Pharmacologie Clinique, CHU de Nantes, France.Service de Pharmacologie Clinique, CHU de Nantes, France.Clinique Médicale pédiatrique, CHU de Nantes, France.Service de Pharmacologie Clinique, CHU de Nantes, France.Clinique Médicale pédiatrique, CHU de Nantes, France.Pharmacie, CHU de Nantes, France.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27147292

Citation

Deslandes, Guillaume, et al. "Stability and Compatibility of Antibiotics in Peritoneal Dialysis Solutions Applied to Automated Peritoneal Dialysis in the Pediatric Population." Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, vol. 36, no. 6, 2016, pp. 676-679.
Deslandes G, Grégoire M, Bouquié R, et al. Stability and Compatibility of Antibiotics in Peritoneal Dialysis Solutions Applied to Automated Peritoneal Dialysis in The Pediatric Population. Perit Dial Int. 2016;36(6):676-679.
Deslandes, G., Grégoire, M., Bouquié, R., Le Marec, A., Allard, S., Dailly, E., ... Navas, D. (2016). Stability and Compatibility of Antibiotics in Peritoneal Dialysis Solutions Applied to Automated Peritoneal Dialysis in The Pediatric Population. Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, 36(6), pp. 676-679.
Deslandes G, et al. Stability and Compatibility of Antibiotics in Peritoneal Dialysis Solutions Applied to Automated Peritoneal Dialysis in the Pediatric Population. Perit Dial Int. 2016;36(6):676-679. PubMed PMID: 27147292.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stability and Compatibility of Antibiotics in Peritoneal Dialysis Solutions Applied to Automated Peritoneal Dialysis in The Pediatric Population. AU - Deslandes,Guillaume, AU - Grégoire,Matthieu, AU - Bouquié,Régis, AU - Le Marec,Aude, AU - Allard,Sophie, AU - Dailly,Eric, AU - Pineau,Alain, AU - Allain-Launay,Emma, AU - Jolliet,Pascale, AU - Roussey,Gwenaëlle, AU - Navas,Dominique, Y1 - 2016/05/04/ PY - 2015/01/20/received PY - 2016/03/15/accepted PY - 2016/5/6/pubmed PY - 2017/12/12/medline PY - 2016/5/6/entrez KW - Dialysis KW - antibiotics KW - compatibility SP - 676 EP - 679 JF - Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis JO - Perit Dial Int VL - 36 IS - 6 N2 - ♦ OBJECTIVES: Assess the stability of several antibiotics in peritoneal dialysis (PD) solutions under common conditions of use in pediatrics, particularly in automated PD. ♦ METHODS: Amoxicillin, cefazolin, cefepime, ceftazidime, imipenem, cotrimoxazole, tobramycin, vancomycin, and the association of ceftazidime + vancomycin and ceftazidime + tobramycin, were tested in 3 different PD solutions: bicarbonate/lactate solution with 2 glucose concentrations (Physioneal 1.36 and 3.86%; Baxter Healthcare Corporation, Deerfield, IL, USA) and an icodextrin-containing solution (Extraneal; Baxter Healthcare Corporation, Deerfield, IL, USA). Concentrations were those recommended in guidelines for the treatment of peritonitis in pediatrics. Physioneal bags were incubated at 37°C for 24 hours, whereas Extraneal bags were stored 12 hours at room temperature (22 ± 2°C) and then 12 hours at 37°C. Drug concentrations were determined using high performance liquid chromatography (HPLC). Each measure was taken in triplicate. Stability of antibiotics was defined as less than 10% degradation of the drug over time. ♦ RESULTS: Cefazolin, cotrimoxazole, tobramycin, and vancomycin were stable under studied conditions. Ceftazidime was stable 24 hours in icodextrin, 12 hours in Physioneal 1.36% and 6 hours in Physioneal 3.86%. The association of tobramycin or vancomycin did not influence the stability of ceftazidime. Cefepime and amoxicillin were stable 6 h, 4 h, and 8 h in Physioneal 1.36%, 3.86% and Extraneal, respectively. The stability of imipenem was very low: 2 h in Physioneal and 6 h in Extraneal. Moreover, an increasingly yellow coloration was observed with the use of imipenem, whereas no color change or precipitation occurred in other bags. ♦ CONCLUSION: Cefazolin, tobramycin, cotrimoxazole, and vancomycin are stable in PD solutions up to 24 hours and can be administered in the PD bag for the treatment of peritonitis, even in automated PD under studied conditions. However, amoxicillin, cefepime, ceftazidime, and imipenem must be used with caution due to their lack of stability. SN - 1718-4304 UR - https://www.unboundmedicine.com/medline/citation/27147292/Stability_and_Compatibility_of_Antibiotics_in_Peritoneal_Dialysis_Solutions_Applied_to_Automated_Peritoneal_Dialysis_in_The_Pediatric_Population_ L2 - http://www.pdiconnect.com/cgi/pmidlookup?view=long&pmid=27147292 DB - PRIME DP - Unbound Medicine ER -