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Influence of Different Peritoneal Dialysis Fluids on the In Vitro Activity of Cefepime, Ciprofloxacin, Ertapenem, Meropenem and Tobramycin Against Escherichia Coli.
Perit Dial Int. 2016 11-12; 36(6):662-668.PD

Abstract

BACKGROUND:

Peritonitis is a major problem among patients on peritoneal dialysis (PD). The influence of diverse PD fluids on the activity of frequently used antibiotics has been insufficiently investigated. Thus, the present study set out to investigate the impact of different PD fluids on the activity of cefepime, ciprofloxacin, ertapenem, meropenem, and tobramycin against Escherichia coli. ♦

METHODS:

Time-kill curves in 4 different PD fluids (Dianeal PDG4, Extraneal, Nutrineal PD4 and Physioneal 40, all Baxter Healthcare Corp., Deerfield, IL, USA) were performed over 24 hours with 4 different concentrations (1 × minimum inhibitory concentration [MIC], 4 × MIC, 8 × MIC, 30 × MIC) of each antibiotic evaluated and without antibiotics as control. Cation-adjusted Mueller Hinton broth (CA-MHB) was used as comparator solution. ♦

RESULTS:

In all PD fluids investigated, bacterial growth and antimicrobial activity of all antibiotics tested was significantly reduced compared with the CA-MHB comparator solution. Except at high concentrations of 30 × MIC, cefepime, ertapenem and meropenem demonstrated a strongly reduced activity in all PD fluids investigated. Ciprofloxacin and tobramycin were highly active and bactericidal in all PD fluids and demonstrated dose-dependent activity. ♦

CONCLUSION:

The antimicrobial activity of cefepime, ertapenem and meropenem is limited or even nullified in certain PD fluids in vitro, whereas ciprofloxacin and tobramycin show excellent activity. The choice of PD fluids can impact the activity of antimicrobial agents and might influence microbiological outcome. Further studies are required to verify the clinical relevance of our findings.

Authors+Show Affiliations

Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University Vienna, Vienna, Austria.Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University Vienna, Vienna, Austria.Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, 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 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 Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University Vienna, Vienna, Austria. Department of Dermatology, Medical University of Vienna, Austria.Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria markus.zeitlinger@meduniwien.ac.at.Department of Internal Medicine I, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27680756

Citation

Kussmann, Manuel, et al. "Influence of Different Peritoneal Dialysis Fluids On the in Vitro Activity of Cefepime, Ciprofloxacin, Ertapenem, Meropenem and Tobramycin Against Escherichia Coli." Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, vol. 36, no. 6, 2016, pp. 662-668.
Kussmann M, Schuster L, Wrenger S, et al. Influence of Different Peritoneal Dialysis Fluids on the In Vitro Activity of Cefepime, Ciprofloxacin, Ertapenem, Meropenem and Tobramycin Against Escherichia Coli. Perit Dial Int. 2016;36(6):662-668.
Kussmann, M., Schuster, L., Wrenger, S., Pichler, P., Reznicek, G., Burgmann, H., Poeppl, W., Zeitlinger, M., & Wiesholzer, M. (2016). Influence of Different Peritoneal Dialysis Fluids on the In Vitro Activity of Cefepime, Ciprofloxacin, Ertapenem, Meropenem and Tobramycin Against Escherichia Coli. Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, 36(6), 662-668.
Kussmann M, et al. Influence of Different Peritoneal Dialysis Fluids On the in Vitro Activity of Cefepime, Ciprofloxacin, Ertapenem, Meropenem and Tobramycin Against Escherichia Coli. Perit Dial Int. 2016 11-12;36(6):662-668. PubMed PMID: 27680756.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of Different Peritoneal Dialysis Fluids on the In Vitro Activity of Cefepime, Ciprofloxacin, Ertapenem, Meropenem and Tobramycin Against Escherichia Coli. AU - Kussmann,Manuel, AU - Schuster,Linda, AU - Wrenger,Sarah, AU - Pichler,Petra, AU - Reznicek,Gottfried, AU - Burgmann,Heinz, AU - Poeppl,Wolfgang, AU - Zeitlinger,Markus, AU - Wiesholzer,Martin, Y1 - 2016/09/28/ PY - 2015/07/09/received PY - 2016/02/22/accepted PY - 2016/9/30/pubmed PY - 2017/12/12/medline PY - 2016/9/30/entrez KW - Antibiotics KW - infection KW - peritoneal dialysis solutions KW - peritonitis KW - time-kill curves SP - 662 EP - 668 JF - Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis JO - Perit Dial Int VL - 36 IS - 6 N2 - ♦ BACKGROUND: Peritonitis is a major problem among patients on peritoneal dialysis (PD). The influence of diverse PD fluids on the activity of frequently used antibiotics has been insufficiently investigated. Thus, the present study set out to investigate the impact of different PD fluids on the activity of cefepime, ciprofloxacin, ertapenem, meropenem, and tobramycin against Escherichia coli. ♦ METHODS: Time-kill curves in 4 different PD fluids (Dianeal PDG4, Extraneal, Nutrineal PD4 and Physioneal 40, all Baxter Healthcare Corp., Deerfield, IL, USA) were performed over 24 hours with 4 different concentrations (1 × minimum inhibitory concentration [MIC], 4 × MIC, 8 × MIC, 30 × MIC) of each antibiotic evaluated and without antibiotics as control. Cation-adjusted Mueller Hinton broth (CA-MHB) was used as comparator solution. ♦ RESULTS: In all PD fluids investigated, bacterial growth and antimicrobial activity of all antibiotics tested was significantly reduced compared with the CA-MHB comparator solution. Except at high concentrations of 30 × MIC, cefepime, ertapenem and meropenem demonstrated a strongly reduced activity in all PD fluids investigated. Ciprofloxacin and tobramycin were highly active and bactericidal in all PD fluids and demonstrated dose-dependent activity. ♦ CONCLUSION: The antimicrobial activity of cefepime, ertapenem and meropenem is limited or even nullified in certain PD fluids in vitro, whereas ciprofloxacin and tobramycin show excellent activity. The choice of PD fluids can impact the activity of antimicrobial agents and might influence microbiological outcome. Further studies are required to verify the clinical relevance of our findings. SN - 1718-4304 UR - https://www.unboundmedicine.com/medline/citation/27680756/Influence_of_Different_Peritoneal_Dialysis_Fluids_on_the_In_Vitro_Activity_of_Cefepime_Ciprofloxacin_Ertapenem_Meropenem_and_Tobramycin_Against_Escherichia_Coli_ L2 - http://journals.sagepub.com/doi/full/10.3747/pdi.2015.00161?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -