Intraperitoneal cefazolin and ceftazidime effects on human peritoneal mesothelial cell release of cancer antigen-125.
BACKGROUND
Intraperitoneal (IP) cefazolin and ceftazidime are recommended as empiric treatment for peritoneal dialysis (PD)-associated peritonitis. Human peritoneal mesothelial cells (HPMCs) may be affected by high IP cefazolin and ceftazidime concentrations. Peritoneal dialysate cancer antigen-125 (CA-125) appearance rate can be used to measure HPMC damage.


OBJECTIVE
To determine whether IP cefazolin and ceftazidime increase peritoneal CA-125 appearance rate.


METHODS
The study consisted of 2 phases. In phase I, no antibiotic was administered, and in phase II, patients received IP cefazolin and ceftazidime (15 mg/kg rounded to nearest 100 mg). Phase II occurred immediately after phase I. Each phase used a 4-hour dwell time with 2 L of dextrose 2.5% dialysate. Dialysate samples were collected at 0, 0.5, 1, 2, and 4 hours during each phase. Samples were assayed for CA-125, and CA-125 appearance rate was calculated.


RESULTS
Thirteen patients were recruited (7 men; aged 44.0 +/-16.0 y). The mean +/- SD (range) CA-125 dialysate concentration after phases I and II were 6.6 +/- 3.7 U/mL (2.3-15.0) and 6.4 +/-3.8 U/mL (1.6-13.8), respectively (p = 0.46). The CA-125 appearance rate after phases I and II were 51.9 +/- 31.3 U/min/1.73 m(2) (13.8-113.0) and 50.5 +/- 32.9 U/min/1.73 m(2) (11.0-104.0), respectively (p = 0.57). The slopes of the regression lines of CA-125 appearance rate were not significantly different between phases I and II.


CONCLUSIONS
These findings demonstrate that concurrently administered IP cefazolin and ceftazidime have no effect on HPMC release of CA-125 in non-infected PD patients.
Manley
Harold J
HJ
School of Pharmacy, University of Missouri, Kansas City, MO, USA. ManleyH@ACP.edu
Elwell
Rowland J
RJ
Bailie
George R
GR
Welch
Charles L
CL
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers; D018394:CA-125 Antigen / Q000378:metabolism*; D002437:Cefazolin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002442:Ceftazidime / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004847:Epithelial Cells / Q000378:metabolism; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity / Q000166:cytology; D010530:Peritoneal Dialysis / Q000009:adverse effects; D010538:Peritonitis / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012044:Regression Analysis; D013997:Time Factors
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D018394:CA-125 Antigen; D002442:Ceftazidime; D002437:Cefazolin