Manuel Kussmann1, Linda Schuster1, Sarah Wrenger1, Petra Pichler2, Gottfried Reznicek3, Heinz Burgmann1, Wolfgang Poeppl1,4, Markus Zeitlinger5, Martin Wiesholzer2. 1. Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University Vienna, Vienna, Austria. 2. Department of Internal Medicine I, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria. 3. Department of Pharmacognosy, University of Vienna, Vienna, Austria. 4. Department of Dermatology, Medical University of Vienna, Austria. 5. Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria markus.zeitlinger@meduniwien.ac.at.
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.
♦ 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.
Authors: Margarete M Silva; Roberto Pecoits-Filho; Carla S Rocha; Andréa E M Stinghen; Maria A Pachaly; Marcelo M Nascimento; Rodrigo P Campos; Sirlene Sauthier; Roseana Fuerbringer; Miguel C Riella Journal: Adv Perit Dial Date: 2004
Authors: M Kussmann; A Baumann; S Hauer; P Pichler; M Zeitlinger; M Wiesholzer; H Burgmann; W Poeppl; G Reznicek Journal: Eur J Clin Microbiol Infect Dis Date: 2017-07-06 Impact factor: 3.267
Authors: Manuel Kussmann; Alexander Ferth; Markus Obermüller; Petra Pichler; Markus Zeitlinger; Martin Wiesholzer; Heinz Burgmann; Wolfgang Poeppl; Gottfried Reznicek Journal: Sci Rep Date: 2019-04-24 Impact factor: 4.379
Authors: Manuel Kussmann; Stefan Hauer; Petra Pichler; Gottfried Reznicek; Heinz Burgmann; Wolfgang Poeppl; Markus Zeitlinger; Martin Wiesholzer Journal: Eur J Clin Microbiol Infect Dis Date: 2018-03-15 Impact factor: 3.267