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Stability of Ceftazidime and Heparin in Four Different Types of Peritoneal Dialysis Solutions.
Perit Dial Int 2018 Jan-Feb; 38(1):49-56PD

Abstract

BACKGROUND

Intraperitoneal (IP) administration of ceftazidime is recommended for the treatment of peritoneal dialysis-associated peritonitis (PDAP) from Pseudomonas. Patients with PDAP may also need IP heparin to overcome problems with drainage of turbid peritoneal dialysis (PD) fluids and blockage of catheters with fibrin. Physico-chemical stability of ceftazidime and heparin, and biological stability of heparin in many types of PD solutions is unknown. Therefore, we investigated the stability of ceftazidime and heparin in 4 types of PD solutions.

METHODS

A total of 12 PD bags (3 for each type of solution) containing ceftazidime and heparin were prepared and stored at 4°C for 120 hours, and then at 25°C for 6 hours, and finally at 37°C for 12 hours. An aliquot was withdrawn after predefined time points and analyzed for the concentration of ceftazidime and heparin using high-performance liquid-chromatography (HPLC). Samples were assessed for pH, color changes, particle content, and anticoagulant activity of heparin.

RESULTS

Ceftazidime and heparin retained more than 91% of their initial concentration when stored at 4°C for 120 hours followed by storage at 25°C for 6 hours and then at 37°C for 12 hours. Heparin retained more than 95% of its initial activity throughout the study period. Particle formation was not detected at any time under the storage conditions. The pH and color remained essentially unchanged throughout the study.

CONCLUSIONS

Ceftazidime-heparin admixture retains its stability over long periods of storage at different temperatures, allowing its potential use for PDAP treatment in outpatient and remote settings.

Authors+Show Affiliations

Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia. Department of Pharmacy, Royal Hobart Hospital, Hobart, Tasmania, Australia.Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia. School of Pharmacy, KPJ Healthcare University College, Nilai, Negeri Sembilan, Malaysia.School of Nursing, University of Sydney, New South Wales, Australia. Peritoneal Dialysis Unit, Regional Dialysis Centre, Blacktown Hospital, Blacktown, New South Wales, Australia.Peritoneal Dialysis Unit, Regional Dialysis Centre, Blacktown Hospital, Blacktown, New South Wales, Australia. Department of Renal Medicine, Nepean Hospital and Nepean Clinical School, University of Sydney, Kingswood, New South Wales, Australia.Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia Rahul.Patel@utas.edu.au.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29162678

Citation

Kandel, Surendra, et al. "Stability of Ceftazidime and Heparin in Four Different Types of Peritoneal Dialysis Solutions." Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, vol. 38, no. 1, 2018, pp. 49-56.
Kandel S, Zaidi STR, Wanandy ST, et al. Stability of Ceftazidime and Heparin in Four Different Types of Peritoneal Dialysis Solutions. Perit Dial Int. 2018;38(1):49-56.
Kandel, S., Zaidi, S. T. R., Wanandy, S. T., Ming, L. C., Castelino, R. L., Sud, K., & Patel, R. P. (2018). Stability of Ceftazidime and Heparin in Four Different Types of Peritoneal Dialysis Solutions. Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, 38(1), pp. 49-56. doi:10.3747/pdi.2017.00115.
Kandel S, et al. Stability of Ceftazidime and Heparin in Four Different Types of Peritoneal Dialysis Solutions. Perit Dial Int. 2018;38(1):49-56. PubMed PMID: 29162678.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stability of Ceftazidime and Heparin in Four Different Types of Peritoneal Dialysis Solutions. AU - Kandel,Surendra, AU - Zaidi,Syed Tabish R, AU - Wanandy,S Troy, AU - Ming,Long C, AU - Castelino,Ronald L, AU - Sud,Kamal, AU - Patel,Rahul P, Y1 - 2017/11/21/ PY - 2017/06/16/received PY - 2017/08/28/accepted PY - 2017/11/23/pubmed PY - 2018/11/6/medline PY - 2017/11/23/entrez KW - Ceftazidime KW - heparin KW - peritoneal dialysis KW - peritonitis KW - stability SP - 49 EP - 56 JF - Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis JO - Perit Dial Int VL - 38 IS - 1 N2 - BACKGROUND: Intraperitoneal (IP) administration of ceftazidime is recommended for the treatment of peritoneal dialysis-associated peritonitis (PDAP) from Pseudomonas. Patients with PDAP may also need IP heparin to overcome problems with drainage of turbid peritoneal dialysis (PD) fluids and blockage of catheters with fibrin. Physico-chemical stability of ceftazidime and heparin, and biological stability of heparin in many types of PD solutions is unknown. Therefore, we investigated the stability of ceftazidime and heparin in 4 types of PD solutions. METHODS: A total of 12 PD bags (3 for each type of solution) containing ceftazidime and heparin were prepared and stored at 4°C for 120 hours, and then at 25°C for 6 hours, and finally at 37°C for 12 hours. An aliquot was withdrawn after predefined time points and analyzed for the concentration of ceftazidime and heparin using high-performance liquid-chromatography (HPLC). Samples were assessed for pH, color changes, particle content, and anticoagulant activity of heparin. RESULTS: Ceftazidime and heparin retained more than 91% of their initial concentration when stored at 4°C for 120 hours followed by storage at 25°C for 6 hours and then at 37°C for 12 hours. Heparin retained more than 95% of its initial activity throughout the study period. Particle formation was not detected at any time under the storage conditions. The pH and color remained essentially unchanged throughout the study. CONCLUSIONS: Ceftazidime-heparin admixture retains its stability over long periods of storage at different temperatures, allowing its potential use for PDAP treatment in outpatient and remote settings. SN - 1718-4304 UR - https://www.unboundmedicine.com/medline/citation/29162678/Stability_of_Ceftazidime_and_Heparin_in_Four_Different_Types_of_Peritoneal_Dialysis_Solutions_ L2 - http://journals.sagepub.com/doi/full/10.3747/pdi.2017.00115?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -