Compatibility of Meropenem with Different Commercial Peritoneal Dialysis Solutions.
♦ BACKGROUND: Intraperitoneal administration of antimicrobial agents is recommended for the treatment of peritoneal dialysis (PD)-related peritonitis. For home-based antimicrobial therapy it is common to supply patients with PD fluid bags with admixed antibiotic. Thus, the compatibility of meropenem with different PD fluids (PDFs), namely Extraneal, Physioneal 1.36% and Physioneal 2.27% (all Baxter Healthcare Corp., Deerfield, IL, USA), was investigated under varying storage conditions. ♦ METHODS: Meropenem (Venus Pharma, Werne, Germany) was stored at 6°C and 25°C over 14 days and at 37°C over 24 hours. Drug concentration over time was determined using high performance liquid chromatography, drug activity by a diffusion disk method, diluent stability by visual inspection and drug adsorption was calculated. Blank PD fluids and deionized water were used as comparator solutions. ♦ RESULTS: Compared to water, the stability of meropenem was minimally lower in Extraneal but markedly reduced in both Physioneal solutions. No significant drug adsorption was detected for any PDF investigated. ♦ CONCLUSIONS: Meropenem is stable and compatible with Extraneal and might be stored for up to a week at refrigeration temperature (6°C). A loss of ~20% of meropenem after 2 days at room temperature should be considered. Mixed Physioneal appears not suitable for storage at any temperature after meropenem has been admixed. A considerable drug degradation due to the warming up to body temperature through heating plates should further be taken into account in clinical practice.
Department of Internal Medicine I, University hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria.
Martin
M
Wiesholzer
Department of Pharmacognosy, University of Vienna, Vienna, Austria.
Alexandra
A
Winter
Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University Vienna, Vienna, Austria.
Manuel
M
Kussmann
Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria.
Markus
M
Zeitlinger
Department of Internal Medicine I, University hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria.
Petra
P
Pichler
Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University Vienna, Vienna, Austria.
Heinz
H
Burgmann
Department of Pharmacognosy, University of Vienna, Vienna, Austria gottfried.reznicek@univie.ac.at.
Gottfried
G
Reznicek
Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University Vienna, Vienna, Austria.|Department of Dermatology, Medical University of Vienna, Austria.
Wolfgang
W
Poeppl
D000900:Anti-Bacterial Agents / Q000737:chemistry* / Q000494:pharmacology; D015314:Dialysis Solutions / Q000737:chemistry*; D004344:Drug Incompatibility; D004355:Drug Stability; D004356:Drug Storage; D006801:Humans; D000077731:Meropenem; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology; D012680:Sensitivity and Specificity; D013845:Thienamycins / Q000737:chemistry* / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D015314:Dialysis Solutions; D013845:Thienamycins; D000077731:Meropenem
Bioactivity; antibiotics; antimicrobial activity; dialysate; drug; intraperitoneal stability; peritonitis