Stability of Cefepime in Icodextrin Peritoneal Dialysis Solution

Elwell, Rowland J.; Volino, Lucio R.; Frye, Reginald F.

doi:10.1345/aph.1e324

Cited by 11 publications

(12 citation statements)

References 6 publications

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“…Table 2 summarizes the antimicrobial stability data of icodextrin in polyolefin and polyvinyl chloride (PVC) containers [58,59,60,61,62]. Stability data for solution in non-PVC containers may not be applicable to containers made of PVC, since some medications may adsorb to the PVC container material [58].…”

Section: Idiopathic Side Effects and Considerationsmentioning

confidence: 99%

Practical Considerations When Prescribing Icodextrin: A Narrative Review

Silver

Harel²,

Perl³

2014

Am J Nephrol

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Background: Icodextrin is a peritoneal dialysis solution that is commonly used to increase ultrafiltration during the long dwell. The other major clinical benefit of icodextrin is that it is glucose-sparing, which may help preserve peritoneal membrane function. Since it has a different chemical composition than dextrose, and with its increasing use, there are several clinical considerations healthcare providers must familiarize themselves with prior to prescribing icodextrin. Summary: Failure to recognize these special properties of icodextrin can lead to adverse events reaching patients. This narrative review explores the hemodynamic, metabolic, and idiopathic effects of icodextrin to facilitate the safe use of icodextrin in peritoneal dialysis. Key Messages: Hemodynamic effects include hypotension from enhanced ultrafiltration contributing to loss of residual kidney function. Metabolic effects include the chemical structure of icodextrin interfering with biochemical assays, resulting in misleading glucose readings on non-specific glucometers. Idiopathic adverse effects include a diffuse rash and sterile peritonitis. It is also important to remember that not all antibiotic combinations have undergone stability testing in icodextrin. This narrative review will help healthcare providers to confidently prescribe icodextrin to maximize its benefit in peritoneal dialysis patients.

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Section: Idiopathic Side Effects and Considerationsmentioning

confidence: 99%

Practical Considerations When Prescribing Icodextrin: A Narrative Review

Silver

Harel²,

Perl³

2014

Am J Nephrol

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“…It has been clinically accepted in other antibiotic stability studies that 90% or more of initial antibiotic concentration remaining was the threshold for stability, therefore we adopted 90% of initial antibiotic concentration remaining as a threshold for stability. 2,6…”

Section: Sample Preparation and Analysismentioning

confidence: 99%

“…Studies investigating the stability of antibiotics in PD solutions have examined ampicillin, cefepime, cephazolin and vancomycin. 2,6 Therefore, due to this evidence of stability, vancomycin, cefepime and cephazolin are now recommended as empirical or specific therapy for intraperitoneal use in the 2010 ISPD guidelines for peritonitis. 3 A study highlighted that ampicillin was unstable in Gambro solution.…”

Section: Introductionmentioning

confidence: 99%

Stability of Amoxycillin, Clindamycin and Meropenem in Peritoneal Dialysis Solution

Tran

Sharley

Ward

2012

Pharmacy Practice and Res

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Aim:To determine the stability of amoxycillin, clindamycin and meropenem in peritoneal dialysis solution containing glucose 2.5% at 37 ºC over 6 hours. Method: A stability-indicating high-performance liquid chromatography assay was used to determine the concentration of amoxycillin, clindamycin and meropenem in peritoneal dialysis solution (Dianeal PD-4). Antibiotic solutions (amoxycillin 1 g, clindamycin 300 mg, meropenem 1 g) were prepared in 2 L peritoneal dialysis bags and stored at 37 ºC. These were analysed at 0, 3 and 6 hours. A degradation profile was constructed for each antibiotic using linear regression and concentration remaining at 6 hours was calculated.

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“…The use of icodextrin formulations (Icodextrin 20) to increase the effi cacy of chemotherapeutics, especially of the cytotoxic drug 5-fl uorouracil, by increasing their dwell time in the peritoneal space is well described. [33,34] Reference is also made to antibiotics, such as cefepime [35] and vancomycin (antibiotic with Gram-positive bacterial coverage), that are stable in the icodextrin solutions, depending essentially on the storage temperature. [36] However, other antibiotics, such as tobramycin (an aminoglycoside antibiotic that provides excellent Gram-negative bacterial coverage) and ceftazidime (a semisynthetic third-generation cephalosporin antibiotic, with coverage for both Gram-negative and Gram-positive organisms) have showed instability in icodextrin solutions.…”

Section: Devices-drug Delivery: Gastromentioning

confidence: 99%

Dextrin

Gonçalves¹,

Moreira²,

Carvalho³

et al. 2016

Encyclopedia of Biomedical Polymers and Polymeric Biomaterials

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Dextrins are low-molecular-weight carbohydrates produced by partial hydrolysis of glycogen or starch achieved by applying dry heat under acidic conditions (pyrolysis or roasting) and/or using enzymes (amylases), malting or mashing. Dextrin is thus a glucose-containing saccharide polymer having the same general formula of starch, but smaller and less complex. Depending on the source and on how it is digested, it can exhibit different structural features (linear, branched, or cyclic) and properties such as hygroscopicity, fermentability, sweetness, stability, gelation, solubility, bioavailability, and molecular compositions. Among starch-derived materials, dextrin is widely used in a variety of applications, namely, adhesives in the manufacture of gummed tapes, textiles and paper, as moisturizing component in cosmetics, or in the food industry. However, its biocompatibility and biodegradability combined with its low cost, abundance, and availability in medical grade make dextrin an excellent polymer for biomedical applications. In this entry, we present an overview of biomedical applications of linear dextrins. The potential of dextrin as tissue engineering scaffolds, hydrogels, drug delivery systems, excipient in tablets, or nanomedicines are thoroughly discussed in this entry. 2636 Dextrin Devices-Drug Delivery: Gastro Dextrin Devices-Drug Delivery: Gastro

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Stability of Cefepime in Icodextrin Peritoneal Dialysis Solution

Cited by 11 publications

References 6 publications

Practical Considerations When Prescribing Icodextrin: A Narrative Review

Practical Considerations When Prescribing Icodextrin: A Narrative Review

Stability of Amoxycillin, Clindamycin and Meropenem in Peritoneal Dialysis Solution

Dextrin

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