Compatibility of linezolid with commercial peritoneal dialysis solutions

Poeppl, Wolfgang; Rainer-Harbach, Elena; Kussmann, Manuel; Pichler, Petra; Zeitlinger, Markus; Wiesholzer, Martin; Burgmann, Heinz; Reznicek, Gottfried

doi:10.2146/ajhp170318

Cited by 3 publications

(11 citation statements)

References 27 publications

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“…Thus, coeluting (degradation) products would lead to significant deviations and poor match scores. In this study peak purities of 0.9999 were found for the aztreonam peaks (range from 0 to 1.0000) attesting an excellent peak purity and thus coeluting degradation products can be excluded 17 . System suitability test of the standard solution gave 0.45% RSD (peak area, n = 6).…”

Section: Sample Analysis By High Performance Liquid Chromatography (Hmentioning

confidence: 50%

“…The injection volume was 5 µl each and the detection wavelength was set to 264 nm to quantify peak areas of standards, samples and possible degradation products, aztreonam eluted at 4.45 min. No shift of the retention time could be observed at all during the complete period of analysis 17 . The quantification was carried out using a calibration curve with aztreonam as external standard.…”

Section: Sample Analysis By High Performance Liquid Chromatography (Hmentioning

confidence: 82%

“…For the chemical analysis of aztreonam stability, a HPLC-system (Shimadzu LC-20 series) was employed consisting of a DGU-20A5 degasser, a LC-20AD quaternary pump, a SIL-20AC autosampler, a CBM-20A communication bus module, a SPD-M20A diode array detector and a CTO-20AC column oven, operated via Shimadzu LabSolutions software 5.57 SP1. LC separation was performed on an Acclaim 120 C18 column (3 µm, 120 Å, 150 × 2.1 mm I.D., serial number 002697, lot number 018-01-139, Thermo Fisher Scientific), preceded by an Acclaim 120 C18 guard cartridge (5 µm, 120 Å, 10 × 2 mm I.D., Thermo Fisher Scientific), at a flow rate of 0.50 mL/min and a column temperature of 25 °C 17 . The mobile phase consisted of a linear gradient mixed from 0.1% aqueous formic acid (mobile phase A) and acetonitrile with 0.1% formic acid (mobile phase B).…”

Section: Sample Analysis By High Performance Liquid Chromatography (Hmentioning

confidence: 99%

“…The gradient started with 9% B to 24% B in 7.5 min, then purging with 95% B for 2.5 min. and again 9% B to equilibrate the column for 5.0 min before application of the next sample (total analysis time 15.0 min) 17 . The injection volume was 5 µl each and the detection wavelength was set to 264 nm to quantify peak areas of standards, samples and possible degradation products, aztreonam eluted at 4.45 min.…”

Section: Sample Analysis By High Performance Liquid Chromatography (Hmentioning

confidence: 99%

“…The autosampler tray was kept at 10 °C, preliminary investigations showed that the storage of the samples in the autosampler at 10 °C till analysis did not affect the aztreonam concentrations at all (data not shown). Each sample series was analyzed within one day, the single samples were analyzed twice (6 measurements per time point and temperature) and the mean value was calculated 17 . Each sample series was interspersed with several Quality Control (QC) samples of known concentrations to ensure the validity of the results.…”

Section: Sample Analysis By High Performance Liquid Chromatography (Hmentioning

confidence: 99%

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Compatibility of aztreonam in four commercial peritoneal dialysis fluids

Tobudic

Prager

Kussmann

et al. 2020

Sci Rep

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the preferable route for treatment of peritoneal dialysis related peritonitis remains the intraperitoneal administration of antibiotics admixed to peritoneal dialysis fluids. It is important to know whether the administered drug is compatible with the PD fluids and its container. In the present study the compatibility of aztreonam with four commercial PDFs at storing temperatures and duration representative for storing conditions in the clinical settings was investigated. Aztreonam concentrations were determined using high-performance liquid chromatography. The antimicrobial activity of aztreonam was evaluated using an E. coli diffusion disk inhibition assay and P. aeruginosa time-kill curves. In Extraneal evaluated at 6 °C, 25 °C and 37 °C aztreonam was stable over the whole study period of 14 days and 24 hours, respectively. In Physioneal and Nutrineal aztreonam was stable at 6 °C for up to 14 days. Antimicrobial activity was retained in all PD fluids over the whole study period. Aztreonam remained stable and was compatible with the PD fluids, particularly with Extraneal or Nutrineal, and no compensatory dose adjustment is needed when stored for up to 14 days at refrigeration temperature before use. Bacterial peritonitis is a serious complication of peritoneal dialysis (PD) which often leads to membrane failure and patients discontinuing from peritoneal dialysis and switching to hemodialysis 1. The most common bacteria isolated from patients with PD associated peritonitis (PDAP) are primarily Gram-positive cocci like Staphylococci or Streptococci, but also Gram-negative bacteria like Escherichia coli or Pseudomonas aeruginosa are frequently detected 2. Particularly P. aeruginosa peritonitis is generally severe and associated with higher frequencies of hospitalization, catheter removal and transfer from PD to hemodialysis (HD) 3-5. Thus, empiric antimicrobial therapy should cover both, the most likely Gram-positive and Gram-negative bacteria. Aztreonam is the only clinically available monobactam with its antibacterial spectrum limited to Gram-negative aerobic bacteria and could be of strong use for the treatment of Gram-negative PDAP. In case of a P. aeruginosa peritonitis the current International Society for Peritoneal Dialysis (ISPD) guidelines suggest treating with two antibiotic agents with different mechanisms of action for three weeks 1. Therefore, aztreonam might be a feasible alternative to cephalosporins or fluoroquinolones, especially due increasing rate of multidrug-resistant Gram-negative bacteria 6. Intraperitoneal (i.p.) administration of drugs is preferable to intravenous or oral routes in PDAP due to the markedly higher concentrations achieved at the target site 1. In the past, aztreonam was assumed to be more cost intensive and more difficult to handle in continuous ambulatory peritoneal dialysis (CAPD), especially compared to fluroquinolones, since it must be administered four times daily 7,8. However, more recent studies have shown that once a day i.p. administration provides sufficient serum...

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Section: Sample Analysis By High Performance Liquid Chromatography (Hmentioning

confidence: 50%

Section: Sample Analysis By High Performance Liquid Chromatography (Hmentioning

confidence: 82%

Section: Sample Analysis By High Performance Liquid Chromatography (Hmentioning

confidence: 99%

Section: Sample Analysis By High Performance Liquid Chromatography (Hmentioning

confidence: 99%

Section: Sample Analysis By High Performance Liquid Chromatography (Hmentioning

confidence: 99%

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Compatibility of aztreonam in four commercial peritoneal dialysis fluids

Tobudic

Prager

Kussmann

et al. 2020

Sci Rep

Self Cite

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Culture-directed antibiotics in peritoneal dialysis solutions: a systematic review focused on stability and compatibility

Ling,

Sud,

Patel

et al. 2023

J Nephrol

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Background This systematic review summarises the stability of less commonly prescribed antibiotics in different peritoneal dialysis solutions that could be used for culture-directed therapy of peritonitis, which would be especially useful in regions with a high prevalence of multidrug antibiotic-resistant strains. Methods A literature search of Medline, Scopus, Embase and Google Scholar for articles published from inception to 25 January, 2023 was conducted. Only antibiotic stability studies conducted in vitro and not recently reviewed by So et al. were included. The main outcomes were chemical, physical, antimicrobial and microbial stability. This protocol was registered in PROSPERO (registration number CRD42023393366). Results We screened 1254 abstracts, and 28 articles were included in the study. In addition to those discussed in a recent systematic review (So et al., Clin Kidney J 15(6):1071–1078, 2022), we identified 18 antimicrobial agents. Of these, 9 have intraperitoneal dosing recommendations in the recent International Society for Peritoneal Dialysis (ISPD) peritonitis guidelines, and 7 of the 9 had stability data applicable to clinical practice. They were cefotaxime, ceftriaxone, daptomycin, ofloxacin, and teicoplanin in glucose-based solutions, tobramycin in Extraneal solution only and fosfomycin in Extraneal, Nutrineal, Physioneal 1.36% and 2.27% glucose solutions. Conclusions Physicochemical stability has not been demonstrated for all antibiotics with intraperitoneal dosing recommendations in the ISPD peritonitis guidelines. Further studies are required to determine the stability of antibiotics, especially in icodextrin-based and low-glucose degradation products, pH-neutral solutions. Graphical abstract

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Stability and compatibility of intraperitoneal antimicrobials in peritoneal dialysate solutions

Lewis,

Alves,

Ratnam

et al. 2023

Perit Dial Int

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To optimise antimicrobial administration in patients with peritoneal dialysis (PD)-related peritonitis, healthcare providers need literature-based information to develop patient-centred pharmacotherapeutic plans. Traditional PD solutions promote osmosis using dextrose or icodextrin with a lactate buffer. Newer PD solutions have modified the osmotic vehicle and buffer. Knowledge of antimicrobial compatibility and stability with newer PD solutions will assist with determining the route of antimicrobial administration as compatible and stable solutions could be delivered directly to the peritoneum using intraperitoneal administration. This review updates the compatibility and stability of antimicrobial additives in newer PD solutions for PD-related peritonitis.

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Compatibility of linezolid with commercial peritoneal dialysis solutions

Cited by 3 publications

References 27 publications

Compatibility of aztreonam in four commercial peritoneal dialysis fluids

Compatibility of aztreonam in four commercial peritoneal dialysis fluids

Culture-directed antibiotics in peritoneal dialysis solutions: a systematic review focused on stability and compatibility

Stability and compatibility of intraperitoneal antimicrobials in peritoneal dialysate solutions

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