Stability of high-dose vancomycin and ceftazidime in peritoneal dialysis solutions

Stamatakis, MK; Leader, W. G.; Tracy, TS

doi:10.1093/ajhp/56.3.246

Cited by 6 publications

(8 citation statements)

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“…Concentrations of tobramycin and ceftazidime in icodextrin solutions were determined using a stability-indicating high-performance liquid chromatography (HPLC) method (14,15). The chromatographic system consisted of a Waters 600 Controller and pump (Waters, Milford, MA, USA), a Waters 717plus Autosampler, and a Waters 996 Photodiode Array Detector.…”

Section: Methodsmentioning

confidence: 99%

Stability of Tobramycin and Ceftazidime in Icodextrin Peritoneal Dialysis Solution

et al. 2009

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Purpose The data describing the compatibility of tobramycin and ceftazidime in icodextrin-based peritoneal dialysis (PD) solution is limited. The objective of this study was to assess the chemical stability of tobramycin and ceftazidime in icodextrin PD solution in polyvinyl chloride containers. Methods Commercially available 2-L bags of icodextrin 7.5% PD solution were used for each sample. Nine tobramycin study samples were prepared by adding 80 mg tobramycin HCl to each bag. Nine ceftazidime samples were prepared by adding 1000 mg ceftazidime to each bag. Three bags of tobramycin–icodextrin solution were stored under each of the following conditions: refrigeration (4°C), room temperature (25°C), and body temperature (37°C). Three bags of ceftazidime–icodextrin solution were also stored at each of the respective temperatures. Samples were withdrawn from each bag immediately after preparation and at predetermined intervals (1, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120, 168, and 336 hours after preparation). Solutions were visually inspected for precipitation, cloudiness, and discoloration at each sampling interval. All samples were immediately frozen (–80°C) after collection and stored prior to assay. Total concentrations of tobramycin and ceftazidime in dialysate fluid were determined by high-performance liquid chromatography. The last time point when tobramycin or ceftazidime concentration was >90% from baseline was used to denote stability. Results All solutions were clear in appearance and no color change or precipitation was observed during the study. For tobramycin, under refrigeration, a mean of 94.6% ± 2.3% of the initial concentration remained at 336 hours (14 days); at room temperature, 90.5% ± 4.3% remained at 168 hours (7 days); at body temperature, 90.0% ± 8.1% remained at 24 hours. For ceftazidime, under refrigeration, a mean of 98.0% ± 0.3% of the initial concentration remained at 168 hours (7 days); at room temperature, 91.6% ± 2.0% remained at 48 hours; at body temperature, 93.9% ± 1.1% remained at 8 hours. Stability was not assessed beyond these respective time points. Conclusion Premixed tobramycin–icodextrin PD solution remains stable for 336 hours (14 days) when refrigerated (4°C) and for 168 hours (7 days) at room temperature (25°C). Ceftazidime–icodextrin PD solution is stable for 168 hours and 48 hours, respectively, when stored at 4°C and 25°C. It is recommended that the bags be kept refrigerated whenever possible. Tobramycin–icodextrin solution stored at body temperature was stable up to 24 hours, and ceftazidime–icodextrin solutions up to 8 hours, permitting the practice of pre-warming solutions prior to administration.

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Section: Methodsmentioning

confidence: 99%

Stability of Tobramycin and Ceftazidime in Icodextrin Peritoneal Dialysis Solution

et al. 2009

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“…To reflect the recommendations given in the SPCs, stability testing was performed for 24 hours at 25°C and for a further 4 hours at 37°C. The compatibility of several drugs in different PD solutions contained in polyvinyl chloride (PVC) material has been reported in the literature (3-7). The PD solutions evaluated in this study are contained in single- and double-chambered bags made of Clear-Flex, which comprises five co-extruded layers of different polyolefins.…”

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confidence: 99%

Stability of Drug Additives in Peritoneal Dialysis Solutions in a New Container

et al. 2004

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Objective To evaluate the stability of gentamicin, tobramycin, netilmycin, vancomycin, cefazolin, unfractionated heparin, and low molecular weight heparin when added to four different peritoneal dialysis (PD) solutions [Extraneal (Baxter Healthcare, Castlebar, Ireland); Physioneal, Nutrineal, and Dianeal (Baxter Healthcare, Grosotto, Italy)] in new, non-PVC Clear-Flex containers. Measurements Gentamicin, tobramycin, netilmycin, vancomycin, cefazolin, unfractionated heparin, and low molecular weight heparin were injected into separate bags of PD solution. Samples were withdrawn at predefined sampling times and the concentration of each drug was analyzed using high-performance liquid chromatography (for gentamicin, tobramycin, vancomycin, and cefazolin), or bioassay (for netilmycin, gentamicin, and tobramycin in Nutrineal), or coagulation methods (heparins). Results Netilmycin, vancomycin, cefazolin, and heparin in Physioneal, Nutrineal, Extraneal, and Dianeal were stable for at least 24 hours at 25°C and for an additional 4 hours at 37°C. Gentamicin in Nutrineal, Extraneal, and Dianeal was stable for at least 24 hours at 25°C and for an additional 4 hours at 37°C; gentamicin in Physioneal was stable for less than 24 hours at 25°C. Tobramycin in Nutrineal and Extraneal was stable for at least 24 hours at 25°C and for an additional 4 hours at 37°C; tobramycin in Physioneal and Dianeal was stable for less than 24 hours at 25°C.

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“…Among the data gathered, only in two papers were all aspects of drug compatibility investigated (30,44). In only 38% of the reports, in addition to drug stability, was diluent stability examined by both visual inspection and pH monitoring (30,38,(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54). Moreover, many studies lacked the use of blank PD solution as a reference.…”

Section: Drug Compatibility and Drug Stability Data In Pd Solutionsmentioning

confidence: 99%

Intraperitoneal Administration of Drugs in Peritoneal Dialysis Patients: A Review of Compatibility and Guidance for Clinical Use

2009

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Peritoneal dialysis (PD) is an effective home-based therapy for end-stage renal failure. Intraperitoneal administration of drugs to PD patients is particularly important for the treatment of peritonitis. Clinicians need to know that the administered drug is compatible with both the PD solution and its container. A detailed literature search on drug compatibility and stability was performed and results of all published stability studies are presented for all drugs, PD solutions, and containers studied. These data will aid clinicians managing PD patients and provide a resource to demonstrate which drugs have been shown to be stable in various PD solutions and solution containers. This is important information to assist clinicians in applying effective treatments, in particular, for peritonitis.

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Stability of high-dose vancomycin and ceftazidime in peritoneal dialysis solutions

Cited by 6 publications

References 0 publications

Stability of Tobramycin and Ceftazidime in Icodextrin Peritoneal Dialysis Solution

Stability of Tobramycin and Ceftazidime in Icodextrin Peritoneal Dialysis Solution

Stability of Drug Additives in Peritoneal Dialysis Solutions in a New Container

Intraperitoneal Administration of Drugs in Peritoneal Dialysis Patients: A Review of Compatibility and Guidance for Clinical Use

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