The Stability and Compatibility of Clindamycin Phosphate and Gentamicin Sulfate Alone and in Combination in Peritoneal Dialysis Solution

1988 ◽  
Vol 8 (2) ◽  
pp. 153-154 ◽  
Author(s):  
William A. Kehoe ◽  
Joel N. Weber ◽  
David S. Fries
Keyword(s):  
Peritoneal Dialysis ◽  
Clindamycin Phosphate ◽  
Gentamicin Sulfate ◽  
Drug Concentrations ◽  
Dialysis Solution ◽  
Peritoneal Dialysis Solution ◽  
Visual Characteristics ◽  
The Times ◽  
The Stability ◽  
Dialysis Solutions

The stability and compatibility of clindamycin phosphate and gentamicin sulfate alone and in combination in peritoneal dialysis solution was studied. Peritoneal dialysis solutions (Dianeal PD-2, Travenol) were prepared in triplicate containing either clindamycin 200 mcg/mL, gentamicin 10 mcg/mL, or a combination of the two. Drug concentrations were determined at intervals over a 96-h period. At each time, solutions were observed for visual incompatibility. No significant changes in drug concentrations or visual characteristics were noted at the times and temperatures tested. We conclude that clindamycin phosphate and gentamicin sulfate are stable and compatible alone and in combination in the peritoneal dialysis solution tested.

Stability of Ceftazidime and Vancomycin Alone and in Combination in Heparinized and Nonheparinized Peritoneal Dialysis Solution

1994 ◽  
Vol 28 (5) ◽  
pp. 572-576 ◽  
Author(s):  
Leigh M. Vaughan ◽  
Cathy Y. Poon
Keyword(s):  
Peritoneal Dialysis ◽  
Room Temperature ◽  
Color Change ◽  
Hplc Assay ◽  
Time Points ◽  
Stability Indicating ◽  
Dialysis Solution ◽  
Peritoneal Dialysis Solution ◽  
The Stability

OBJECTIVE: To examine the stability of ceftazidime, vancomycin, and heparin, alone and in combination, in dialysis solution over six days at three temperatures. DESIGN: Nine 250-mL Dianeal PD-2 dextrose 1.5% bags were prepared with ceftazidime, vancomycin, and heparin alone and in combination at set concentrations of 100 μg/mL, 50 μg/mL, and 1 unit/mL, respectively. Three bags of each mixture were stored at 4, 25, and 37°C. Duplicate samples for analysis were removed from each bag at the following time points: premix, 0, 12, 24, 48, 72, 96, 120, and 144 hours. MAIN OURCOME MEASURES: Each sample was examined visually for signs of cloudiness and precipitation. Each sample was analyzed by stability-indicating HPLC assay for ceftazidime and vancomycin, with stability defined as less than 10 percent degradation of drug overtime. RESULTS: No color change or precipitation was observed in any bag. Vancomycin with or without heparin was stable for 5–6 days at 4, 25, and 37°C. Ceftazidime with and without heparin was stable for 6 days at 4°C, 4 days at 25°C, and less than 12 hours at 37 °C. Vancomycin plus ceftazidime with and without heparin was stable for 6 days at 4 °C and 25°C, and 4–5 days at 37 °C, Ceftazidime plus vancomycin with or without heparin was stable for 6 days at 4°C, 2–3 days at 25°C, and 12 hours at 37 °C. CONCLUSIONS: Bulk preparations of ceftazidime and vancomycin, alone and in combination and with or without heparin in Dianeal PD dextrose 1.5% solution, are sufficiently stable for use up to 6 days under refrigeration or 48 hours at room temperature.

The Use of Alternative Peritoneal Dialysis Solutions in Pediatric Patients

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 95-97 ◽  
Author(s):  
John Williamson Balfe ◽  
Izhar Qamar
Keyword(s):  
Amino Acids ◽  
Peritoneal Dialysis ◽  
Pediatric Patients ◽  
Dialysis Solution ◽  
Peritoneal Dialysis Solution ◽  
Calcium And Magnesium ◽  
Dialysis Solutions ◽  
Osmotic Solute ◽  
Peritoneal Dialysis Solutions

Changes in the formulation of peritoneal dialysis solutions will continue. For the present, dextrose dialysis will remain the osmotic solute of choice. How amino acids and glucose polymers as solute replace ments for glucose fit into the dialysis prescription remains to be seen. The lower concentration of calcium and magnesium appears to be gaining acceptance in many centers. It is feasible that in the next few years the challenge of adding bicarbonate to the peritoneal dialysis solution will be circumvented, because there appears to be a real clinical need for such an improvement. Pediatric modifications will be necessary, appreciating that such changes will have an economic penalty, and thus must have proven value.

Failure of Neutrophils to Recover Their Ability to Produce Superoxide after Stunning by a Conventional, Acidic, Lactate-Based Peritoneal Dialysis Solution

1994 ◽  
Vol 17 (4) ◽  
pp. 191-194 ◽  
Author(s):  
T.S. Ing ◽  
A.W. Yu ◽  
P.V. Podila ◽  
F.Q. Zhou ◽  
E.W. Kun ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Extracellular Ph ◽  
Human Neutrophils ◽  
Superoxide Generation ◽  
Dialysis Solution ◽  
Peritoneal Dialysis Solution ◽  
Dialysis Solutions ◽  
Peritoneal Dialysis Solutions

Exposure of human neutrophils to conventional, acidic, lactate-based peritoneal dialysis solutions for 5 minutes results in a depression of superoxide generation. In spite of restoration of extracellular pH to 7.4, these stunned cells failed to recover their ability to generate the anion after a period of an hour.

Osmotic Agents for Peritoneal Dialysis

1986 ◽  
Vol 9 (6) ◽  
pp. 387-390 ◽  
Author(s):  
R. Khanna ◽  
Z. J. Twardowski ◽  
D.G. Oreopoulos
Keyword(s):  
Amino Acids ◽  
Peritoneal Dialysis ◽  
Sole Agent ◽  
Dialysis Solution ◽  
Osmotic Agent ◽  
Peritoneal Dialysis Solution ◽  
Osmotic Agents ◽  
Near Future ◽  
Dialysis Solutions

Glucose has more advantages than drawbacks and is now the sole agent used in clinical practice. Yet there is interest in finding a substitute for glucose as an osmotic agent in peritoneal dialysis solution. Work has identified several promising agents such as albumin, amino acids, gelatin and glycerol but it appears that every one of them, including glucose, would be useful for a short-dwell or for a long-dwell exchange but not for both. Some of them, such as albumin and the amino acids, are close to being an ideal osmotic agent but are prohibitively costly to manufacture. We predict that interest in the future will focus on dialysis solutions containing a mixture of osmotic agents. Such a solution would be acceptable for both short and long-dwell exchanges. It will have a sufficiently low concentration of different agents to minimize toxicity and long-term undesirable side effects. We expect that solutions will be available to better meet patients needs in the near future.

Inhibition of Caspases Improves Bacterial Clearance in Experimental Peritonitis

2003 ◽  
Vol 23 (2) ◽  
pp. 123-126 ◽  
Author(s):  
◽  
Marina Penélope Catalan ◽  
Jaime Esteban ◽  
Dolores Subirá ◽  
Jesús Egido ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Bacterial Clearance ◽  
Experimental Peritonitis ◽  
Dialysis Solution ◽  
Peritoneal Leukocytes ◽  
Peritoneal Dialysis Solution ◽  
Dialysis Solutions ◽  
Number Of Bacteria ◽  
Peritoneal Dialysis Solutions

Background Inhibition of caspases improves the antibacterial capacity of leukocytes cultured with peritoneal dialysis solutions, and improves the prognosis of septic, polymicrobial experimental peritonitis. Objective To test whether inhibition of caspases alters the evolution of peritonitis in the presence of peritoneal dialysis solution. Design 32 mice were assigned to therapy with either the pan-caspase inhibitor zVAD or vehicle for 48 hours following infection with Staphylococcus aureus, in the presence of lactate-buffered, 4.25% glucose peritoneal dialysis solution. 16 mice received vehicle in phosphate-buffered saline. Main Outcome Measure Number of bacteria recovered from the peritoneum at 48 hours. Results Peritoneal dialysis solution accelerated leukocyte apoptosis. zVAD decreased the number of apoptotic peritoneal leukocytes and the number of bacteria recovered from the peritoneum at 48 hours (zVAD 2.8 ± 0.3 vs vehicle 3.9 ± 0.2 log colony forming units of S. aureus, p = 0.007). Conclusions Inhibition of caspases accelerates peritoneal bacterial clearance in the presence of peritoneal dialysis solutions in vivo in the experimental setting. Inhibition of caspases should be explored as a mean to accelerate recovery following peritonitis in the clinical setting.

Prevention of Peritoneal Sclerosis: A New Proposal to Substitute Glucose with Carnitine Dialysis Solution (Biocompatibility Testing in Vitro and in Rabbits)

2005 ◽  
Vol 28 (2) ◽  
pp. 177-187 ◽  
Author(s):  
E. Gaggiotti ◽  
A. Arduini ◽  
M. Bonomini ◽  
G. Valentini ◽  
G. Sacchi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Solution ◽  
Biocompatibility Testing ◽  
Peritoneal Dialysis Solution ◽  
High Doses ◽  
Near Future ◽  
Dialysis Solutions ◽  
Peritoneal Dialysis Solutions

Aim Commercial glucose peritoneal dialysis solutions expose the peritoneum to hyperosmolar glucose containing variable amounts of non-enzymic breakdown products of glucose. These solutions are toxic for the peritoneum. The aim of the present study is to compare in vitro and in vivo characteristics of a new dialysis solution containing carnitine, a naturally occurring compound, as substitute of glucose. Material and Methods We compared in vitro and in the rabbit a new peritoneal dialysis solution containing carnitine, with two standard bicarbonate glucose peritoneal dialysis solutions and a solution containing icodextrin. Results In vitro and in vivo the solution containing carnitine seems to be more biocompatible than standard glucose solutions and those containing icodextrin. Conclusions In our study the peritoneal dialysis solution containing carnitine seems to prevent the mesothelial changes observed with solutions containing glucose. Since carnitine has been extensively studied and seems to be well tolerated by hemodialysis patients, even at high doses for long periods, clinical trials in humans may be planned in the near future.

Compatibility of Cefazolin and Gentamicin in Peritoneal Dialysis Solutions

1986 ◽  
Vol 20 (9) ◽  
pp. 697-700 ◽  
Author(s):  
Paul C. Walker ◽  
Ralph E. Kaufmann ◽  
Neil Massoud
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Statistical Significance ◽  
Drug Assay ◽  
Dialysis Solution ◽  
Gentamicin Concentration ◽  
Peritoneal Dialysis Solution ◽  
Concentration Changes ◽  
Dialysis Solutions ◽  
Peritoneal Dialysis Solutions

The compatibility of cefazolin and gentamicin in fluid commonly used for continuous ambulatory peritoneal dialysis (CAPD) was studied. Five admixtures containing cefazolin (75 mg/L and 150 mg/L) and gentamicin (8 mg/L), alone and in combination, were prepared in 1.5% dextrose peritoneal dialysis solution. Solutions were stored for 48 hours at 4°C, 26°C, and 37°C; aliquots for drug assay were obained at 0, 4, 8, 24, and 48 hours. HPLC and immunofluorescent assays were used to determine cefazolin and gentamicin concentrations, respectively. The cefazolin and gentamicin concentration changes over the study period did not reach statistical significance. Maximal cefazolin and gentamicin losses (12 and 7 percent of the initial concentrations, respectively) were observed at 48 hours in solutions stored at 37°C. No significant differences in concentration changes were observed between combination solutions and solutions containing either cefazolin or gentamicin alone. Cefazolin and gentamicin, alone or in combination, are compatible for at least 48 hours in CAPD solutions.

Compatibility and Stability of Clindamycin Phosphate-Aminoglycoside Combinations Within Polypropylene Syringes

1987 ◽  
Vol 21 (10) ◽  
pp. 806-810 ◽  
Author(s):  
Arthur S. Zbrozek ◽  
Dwight A. Marble ◽  
John A. Bosso ◽  
Jan N. Bair ◽  
Raymond J. Townsend
Keyword(s):  
High Performance ◽  
Storage Conditions ◽  
Initial Contact ◽  
Clindamycin Phosphate ◽  
Specific Storage ◽  
Gentamicin Sulfate ◽  
Drug Concentrations ◽  
Amikacin Sulfate ◽  
The Stability ◽  
Tobramycin Sulfate

The stability and compatibility of clindamycin phosphate admixed separately with gentamicin sulfate, tobramycin sulfate, and amikacin sulfate in polypropylene syringes under specific storage conditions were studied. In duplicate syringes, clindamycin phosphate 900 mg was admixed with sterile NaCl 0.9% 1 ml and with either gentamicin sulfate 120 mg, tobramycin sulfate 120 mg, or amikacin sulfate 750 mg. In duplicate polypropylene syringes, control solutions of clindamycin phosphate and each aminoglycoside were prepared separately and stored under the same conditions. The clindamycin control consisted of clindamycin phosphate 900 mg in 6 ml. The gentamicin and tobramycin controls consisted of gentamicin sulfate and tobramycin sulfate 120 mg in 3 ml plus 1 ml of sterile NaCl 0.9%. The amikacin control consisted of amikacin sulfate 750 mg in 3 ml plus 1 ml of sterile NaCl 0.9%. Drug concentrations were determined at the time of preparation and 1, 4, 8, 12, 24, and 48 hours thereafter. Aminoglycosides were assayed by fluorescence polarization immunoassay and clindamycin was assayed by high performance liquid chromatography. Visual inspections and pH determinations of each combination and control solution were performed at each assay time. For the clindamycin, gentamicin, tobramycin, and amikacin control solutions, changes in concentration were within ten percent of the original concentration. Concentrations of clindamycin and gentamicin when admixed together also remained within ten percent of the original concentration. Similar results were found with concentrations of clindamycin and amikacin when admixed together. Tobramycin and clindamycin formed a lasting precipitate upon initial contact when admixed under the study conditions.

Neutrophilic Intracellular Acidosis Induced by Conventional, Lactate-Containing Peritoneal Dialysis Solutions

1992 ◽  
Vol 15 (11) ◽  
pp. 661-665 ◽  
Author(s):  
A.W. Yu ◽  
X.J. Zhou ◽  
F.Q. Zhou ◽  
Z.M. Nawab ◽  
V.C. Gandhi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Human Neutrophils ◽  
Intracellular Acidosis ◽  
Dialysis Solution ◽  
Peritoneal Dialysis Solution ◽  
Cellular Dysfunction ◽  
Dialysis Solutions ◽  
Peritoneal Dialysis Solutions

Exposure of human neutrophils to a conventional, acidic, lactate-containing peritoneal dialysis solution (PDS) resulted in the development of a prompt and substantial intracellular acidosis. It is possible that this intracellular acidosis contributes to cellular dysfunction.

In Vivo Model to Study the Biocompatibility of Peritoneal Dialysis Solutions

1997 ◽  
Vol 20 (12) ◽  
pp. 673-677 ◽  
Author(s):  
K. Wieczorowska-Tobis ◽  
K. Korybalska ◽  
A. Polubinska ◽  
M. Radkowski ◽  
A. Breborowicz ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Rat Model ◽  
Qualitative Assessment ◽  
In Vivo Model ◽  
Dialysis Solution ◽  
Male Wistar Rats ◽  
Catheter Implantation ◽  
Peritoneal Dialysis Solution ◽  
Dialysis Solutions

This study was designed to analyze the complex morphologic and functional effects of dialysis solutions on peritoneum in a rat model on chronic peritoneal dialysis. Peritoneal catheters were inserted into 10 male, Wistar rats and the animals were dialyzed twice daily for 4 weeks with 4.25% Dianeal. During the study we observed two opposite effects: healing of the peritoneum after catheter implantation - decreased cell count in dialysate, decreased permeability of the peritoneum to glucose and total protein, increased volume of drained dialysate; and damage to the membrane due to its exposure to peritoneal dialysis solution - increased hyaluronic acid levels in dialysate, a tendency of the peritoneum to thicken when compared to non-dialyzed animals. Our rat model of CAPD may be used for quantitative and qualitative assessment of the effects of peritoneal dialysis solution on the peritoneum during chronic dialysis

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