ABSTRACT
Peritoneal
dialysate fluid (PDF) is a bacteriostatic medium that compromises the
antibacterial activity of cell wall-active agents. By use of an in
vitro static model, methicillin-resistant Staphylococcus
aureus (MRSA), methicillin-susceptible S. aureus (MSSA),
methicillin-susceptible Staphylococcus epidermidis (MSSE), and
Streptococcus sanguis were exposed to daptomycin
at concentrations of 10, 30, and 100 mg/liter, cefazolin at 125
mg/liter, and vancomycin at 25 mg/liter in cation-adjusted
Mueller-Hinton Broth or Todd Hewitt Broth (for S. sanguis) and
PDF at pHs of 5.5 and 7.4. The pH had no effect on antibacterial
activity. Neither cefazolin nor vancomycin produced a bactericidal or a
bacteriostatic effect versus MRSA, MSSA, MSSE, or S. sanguis
in PDF, while all concentrations of daptomycin were bactericidal
against all organisms in PDF. Daptomycin did not exhibit
concentration-dependent activity in PDF. Daptomycin appears to be a
promising agent for use in peritoneal dialysis-associated peritonitis,
producing bacterial kill to a greater extent and at a higher rate than
cefazolin or vancomycin in
PDF.