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Compatibility of Meropenem with Different Commercial Peritoneal Dialysis Solutions.
Perit Dial Int 2017 1-2; 37(1):51-55PD

Abstract

BACKGROUND:

Intraperitoneal administration of antimicrobial agents is recommended for the treatment of peritoneal dialysis (PD)-related peritonitis. For home-based antimicrobial therapy it is common to supply patients with PD fluid bags with admixed antibiotic. Thus, the compatibility of meropenem with different PD fluids (PDFs), namely Extraneal, Physioneal 1.36% and Physioneal 2.27% (all Baxter Healthcare Corp., Deerfield, IL, USA), was investigated under varying storage conditions. ♦

METHODS:

Meropenem (Venus Pharma, Werne, Germany) was stored at 6°C and 25°C over 14 days and at 37°C over 24 hours. Drug concentration over time was determined using high performance liquid chromatography, drug activity by a diffusion disk method, diluent stability by visual inspection and drug adsorption was calculated. Blank PD fluids and deionized water were used as comparator solutions. ♦

RESULTS:

Compared to water, the stability of meropenem was minimally lower in Extraneal but markedly reduced in both Physioneal solutions. No significant drug adsorption was detected for any PDF investigated. ♦

CONCLUSIONS:

Meropenem is stable and compatible with Extraneal and might be stored for up to a week at refrigeration temperature (6°C). A loss of ~20% of meropenem after 2 days at room temperature should be considered. Mixed Physioneal appears not suitable for storage at any temperature after meropenem has been admixed. A considerable drug degradation due to the warming up to body temperature through heating plates should further be taken into account in clinical practice.

Authors+Show Affiliations

Department of Internal Medicine I, University hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria.Department of Pharmacognosy, University of Vienna, Vienna, Austria.Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University Vienna, Vienna, Austria.Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria.Department of Internal Medicine I, University hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria.Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University Vienna, Vienna, Austria.Department of Pharmacognosy, University of Vienna, Vienna, Austria gottfried.reznicek@univie.ac.at.Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University Vienna, Vienna, Austria. Department of Dermatology, Medical University of Vienna, Austria.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27605684

Citation

Wiesholzer, Martin, et al. "Compatibility of Meropenem With Different Commercial Peritoneal Dialysis Solutions." Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, vol. 37, no. 1, 2017, pp. 51-55.
Wiesholzer M, Winter A, Kussmann M, et al. Compatibility of Meropenem with Different Commercial Peritoneal Dialysis Solutions. Perit Dial Int. 2017;37(1):51-55.
Wiesholzer, M., Winter, A., Kussmann, M., Zeitlinger, M., Pichler, P., Burgmann, H., ... Poeppl, W. (2017). Compatibility of Meropenem with Different Commercial Peritoneal Dialysis Solutions. Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, 37(1), pp. 51-55. doi:10.3747/pdi.2016.00018.
Wiesholzer M, et al. Compatibility of Meropenem With Different Commercial Peritoneal Dialysis Solutions. Perit Dial Int. 2017;37(1):51-55. PubMed PMID: 27605684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Compatibility of Meropenem with Different Commercial Peritoneal Dialysis Solutions. AU - Wiesholzer,Martin, AU - Winter,Alexandra, AU - Kussmann,Manuel, AU - Zeitlinger,Markus, AU - Pichler,Petra, AU - Burgmann,Heinz, AU - Reznicek,Gottfried, AU - Poeppl,Wolfgang, Y1 - 2016/09/07/ PY - 2016/01/17/received PY - 2016/04/23/accepted PY - 2016/9/9/pubmed PY - 2017/12/12/medline PY - 2016/9/9/entrez KW - Bioactivity KW - antibiotics KW - antimicrobial activity KW - dialysate KW - drug KW - intraperitoneal stability KW - peritonitis SP - 51 EP - 55 JF - Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis JO - Perit Dial Int VL - 37 IS - 1 N2 - ♦ BACKGROUND: Intraperitoneal administration of antimicrobial agents is recommended for the treatment of peritoneal dialysis (PD)-related peritonitis. For home-based antimicrobial therapy it is common to supply patients with PD fluid bags with admixed antibiotic. Thus, the compatibility of meropenem with different PD fluids (PDFs), namely Extraneal, Physioneal 1.36% and Physioneal 2.27% (all Baxter Healthcare Corp., Deerfield, IL, USA), was investigated under varying storage conditions. ♦ METHODS: Meropenem (Venus Pharma, Werne, Germany) was stored at 6°C and 25°C over 14 days and at 37°C over 24 hours. Drug concentration over time was determined using high performance liquid chromatography, drug activity by a diffusion disk method, diluent stability by visual inspection and drug adsorption was calculated. Blank PD fluids and deionized water were used as comparator solutions. ♦ RESULTS: Compared to water, the stability of meropenem was minimally lower in Extraneal but markedly reduced in both Physioneal solutions. No significant drug adsorption was detected for any PDF investigated. ♦ CONCLUSIONS: Meropenem is stable and compatible with Extraneal and might be stored for up to a week at refrigeration temperature (6°C). A loss of ~20% of meropenem after 2 days at room temperature should be considered. Mixed Physioneal appears not suitable for storage at any temperature after meropenem has been admixed. A considerable drug degradation due to the warming up to body temperature through heating plates should further be taken into account in clinical practice. SN - 1718-4304 UR - https://www.unboundmedicine.com/medline/citation/27605684/Compatibility_of_Meropenem_with_Different_Commercial_Peritoneal_Dialysis_Solutions_ L2 - http://www.pdiconnect.com/cgi/pmidlookup?view=long&pmid=27605684 DB - PRIME DP - Unbound Medicine ER -