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Kidney Week

Abstract: SA-PO630

Pharmacokinetics of Intraperitoneal Cefazolin and Ceftazidime in Automated Peritoneal Dialysis Patients with Peritonitis

Session Information

  • Pharmacology
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

  • 1700 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

Authors

  • Triyawatanyu, Pinpongsarn, Chulalongkorn university, Nongkhai, Thailand
  • Katavetin, Pisut, King Chulalongkorn Memorial Hospital, Thai Red Cross Society and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Chariyavilaskul, Pajaree, Chulalongkorn University, Bangkok, Thailand
  • Phaisal, Weeraya, chulalongkorn university, Bangkok, Thailand
  • Peerapornratana, Sadudee, Chulalongkorn University, Bangkok, Thailand
  • Kanjanabuch, Talerngsak, Chulalongkorn University, Bangkok, Thailand
  • Praditpornsilpa, Kearkiat, Chulalongkorn University, Bangkok, Thailand
  • Eiam-Ong, Somchai, Chulalongkorn University, Bangkok, Thailand
Background

The current peritoneal dialysis (PD) guideline suggested that intraperitoneal (IP) antibiotics should be administered only in a long dwell (≥6 hours). We previously showed that IP cefazolin and ceftazidime during short-dwell cycling PD (<2-hour) could provide adequate plasma concentration for up to 24 hours in non-peritonitis patients. This study was aimed to evaluate bioavailability, as well as plasma and dialysate concentration of IP cefazolin and ceftazidime during short-dwell cycling PD in patients with peritonitis.

Methods

PD patients with peritonitis were enrolled. Cefazolin and ceftazidime (2,500 mg each) were added in a 5-liter bag containing 2.5% dextrose PD fluid, placed on the warmer of PD cycling machine. Another 5-liter bag of PD fluid was connected to the machine, off the warmer. Patients underwent 5 exchanges of 2-liter PD fluid over 10 hours by the PD cycling machine without last fill or additional dwell. Antibiotics concentrations were determined by high-performance liquid chromatography.

Results

Six PD patients with peritonitis participated in this study. The IP bioavailability of cefazolin and ceftazidime were 50.3±16.4% and 56.6±18.4%, respectively. Plasma cefazolin and ceftazidime levels exceeded the minimum inhibitory concentration (MIC) of 8 mg/L within the first hour (cefazolin 37.0±6.5 and ceftazidime 21.4±5.7 mg/L), peak at 10 hours (100.1±4.0 and 54.0±14.5 mg/L) and then sustained well above the MIC at 24 hours after the infusion (82.3±3.2 and 40.2±10.5 mg/L). Dialysate cefazolin and ceftazidime levels were also sustained above the MIC throughout the PD session in all patients.

Conclusion

The IP cefazolin and ceftazidime during short dwells in peritonitis patients provided sufficient bioavailability as well as adequate plasma and dialysate concentrations. This regimen should be one of the standard regimens for treatment of peritonitis in PD patients.

Funding

  • Government Support - Non-U.S.