Original Research
Sunday, November 12, 2023
12:45 PM–02:15 PM
Abstract
Introduction:
The preferred method to treat peritoneal dialysis-related peritonitis (PDRP) is the intraperitoneal (IP) administration of antibiotics admixed with peritoneal dialysis solution (PDS). Vancomycin and cefepime added to PDS is a therapeutic option for PDRP but stability and compatibility data for this admixture are limited.
Research Question or Hypothesis:
Are vancomycin (1 mg/mL) and cefepime (0.5 mg/L) when added to a PDS stable and compatible under varying temperatures over time?
Study Design:
In-vitro study
Methods:
Vancomycin (1 mg/mL) and cefepime (0.5 mg/mL) were added to Dianeal 2.5% and Extraneal 2.5%. The admixtures were prepared in triplicate and stored at 4°C, 25°C, or 37°C for 7 days. Aliquots were obtained at baseline and predefined time points up to 7 days. Stability was determined by stability-indicating high-performance liquid chromatography and defined as the drug retaining =90% of the initial drug concentration (IDC). Physical compatibility was determined by visual inspection, pH, and absorbance.
Results:
Vancomycin and cefepime concentrations in both PDS declined over time but cefepime degradation occurred at a faster rate. Vancomycin retained =90% of its IDC for 7 days at 4°C and 25°C, and 5 days at 37°C in both PDS. Cefepime’s IDC was =90% for 7 days at 4°C and 4 days at 25°C in both PDS, but <90% after 8 hours and 1 day at 37°C in Dianeal and Extraneal respectively. Visual changes were noted when a yellow colorization occurred after 2 days at 37°C. Absorbance and pH remain unchanged.
Conclusion:
Our in vitro study found that vancomycin and cefepime were physically compatible in both PDS although cefepime concentrations were suboptimal within 8 hours in Dianeal.
Presenting Author
Susan Lewis PharmDUniversity of Findlay College of Pharmacy
Authors
Julie Oestreich Pharm.D., Ph.D.
University of Findlay
Mariann Churchwell PharmD, BCPS, FCCP
The University of Toledo
Richard Dudley PhD
University of Findlay