Influence of Different Peritoneal Dialysis Fluids on the In Vitro Activity of Cefepime, Ciprofloxacin, Ertapenem, Meropenem and Tobramycin Against Escherichia Coli

Manuel Kussmann, Linda Schuster, Sarah Wrenger, Petra Pichler, Gottfried Reznicek, Heinz Burgmann, Wolfgang Poeppl, Markus Zeitlinger, Martin Wiesholzer

Research output: Journal article (peer-reviewed)Journal article

9 Citations (Scopus)

Abstract

♦ BACKGROUND: Peritonitis is a major problem among patients on peritoneal dialysis (PD). The influence of diverse PD fluids on the activity of frequently used antibiotics has been insufficiently investigated. Thus, the present study set out to investigate the impact of different PD fluids on the activity of cefepime, ciprofloxacin, ertapenem, meropenem, and tobramycin against Escherichia coli. ♦ METHODS: Time-kill curves in 4 different PD fluids (Dianeal PDG4, Extraneal, Nutrineal PD4 and Physioneal 40, all Baxter Healthcare Corp., Deerfield, IL, USA) were performed over 24 hours with 4 different concentrations (1 × minimum inhibitory concentration [MIC], 4 × MIC, 8 × MIC, 30 × MIC) of each antibiotic evaluated and without antibiotics as control. Cation-adjusted Mueller Hinton broth (CA-MHB) was used as comparator solution. ♦ RESULTS: In all PD fluids investigated, bacterial growth and antimicrobial activity of all antibiotics tested was significantly reduced compared with the CA-MHB comparator solution. Except at high concentrations of 30 × MIC, cefepime, ertapenem and meropenem demonstrated a strongly reduced activity in all PD fluids investigated. Ciprofloxacin and tobramycin were highly active and bactericidal in all PD fluids and demonstrated dose-dependent activity. ♦ CONCLUSION: The antimicrobial activity of cefepime, ertapenem and meropenem is limited or even nullified in certain PD fluids in vitro, whereas ciprofloxacin and tobramycin show excellent activity. The choice of PD fluids can impact the activity of antimicrobial agents and might influence microbiological outcome. Further studies are required to verify the clinical relevance of our findings.

Original languageEnglish
Pages (from-to)662-668
Number of pages7
JournalPeritoneal Dialysis International
Volume36
Issue number6
DOIs
Publication statusPublished - 1 Nov 2016

Keywords

  • Anti-Bacterial Agents/pharmacology
  • Cefepime
  • Cephalosporins/pharmacology
  • Ciprofloxacin/pharmacology
  • Dialysis Solutions/adverse effects
  • Ertapenem
  • Escherichia coli/drug effects
  • Humans
  • In Vitro Techniques
  • Meropenem
  • Microbial Sensitivity Tests
  • Peritoneal Dialysis/adverse effects
  • Peritonitis/drug therapy
  • Sensitivity and Specificity
  • Thienamycins/pharmacology
  • Tobramycin/pharmacology
  • beta-Lactams/pharmacology
  • Time-kill curves
  • Peritoneal dialysis solutions
  • Infection
  • Antibiotics
  • Peritonitis

ASJC Scopus subject areas

  • Nephrology

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