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Stability of ceftolozane and tazobactam in different peritoneal dialysis solutions


Harmanjeet, H and Jani, H and Zaidi, STR and Wanandy, T and Castelino, RL and Sud, K and Peterson, GM and Patel, RP, Stability of ceftolozane and tazobactam in different peritoneal dialysis solutions, Peritoneal Dialysis International, 40, (5) pp. 470-476. ISSN 0896-8608 (2020) [Refereed Article]

Copyright Statement

Copyright The Author(s) 2020

DOI: doi:10.1177/0896860820902590


Background: Peritonitis is a common and serious complication of peritoneal dialysis (PD). PD-associated peritonitis (PDAP) caused by Pseudomonas is usually resistant to most antibiotics, resulting in high failure rates. Ceftolozane/tazobactam (C/T) has been shown to be effective in treating urinary tract and intra-abdominal infections caused by beta-lactam resistant Pseudomonas and other gram-negative bacteria. Given its favourable adverse effects profile, it has a potential role in the treatment of PDAP caused by Pseudomonas species resistant to other antibiotics. Intraperitoneal administration of antibiotics admixed with PD solutions for the treatment of PDAP is associated with superior outcomes. However, there is a lack of published data on the stability of C/T in PD solutions. Therefore, this study investigated the physical and chemical stability of C/T in commonly used PD solutions at different temperatures.

Methods: A total of 27 PD bags (3 PD bags for each type of PD solution including Dianeal®, Extraneal®, Balance® and Physioneal® PD bags) containing C/T were prepared and stored at 25C for 6 h, followed by 4C for 168 h and then 37C for 12 h. An aliquot from each PD bag was withdrawn, and the concentration of C/T before (0 h) and after predefined time points was determined using a stability-indicating high-performance liquid chromatography assay. Samples were also assessed for pH, colour change and particulate matter immediately after preparation and on each day of analysis.

Results: C/T retained more than 97% of their initial concentration when stored at 25C for 6 h followed by storage at 4C for 168 h and then at 37C for 12 h. Particle formation was not detected at any time under the tested storage conditions. The pH and colour remained essentially unchanged throughout the study.

Conclusions: These results provide a platform for clinical studies to determine the safety and therapeutic efficacy of intraperitoneal C/T for the treatment of PDAP caused by resistant Pseudomonas species.

Item Details

Item Type:Refereed Article
Keywords:Stability, HPLC, antibiotic, infection, peritoneal dialysis
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Basic pharmacology
Objective Division:Health
Objective Group:Other health
Objective Field:Other health not elsewhere classified
UTAS Author:Harmanjeet, H (Mr Harmanjeet Harmanjeet)
UTAS Author:Jani, H (Mr Het Jani)
UTAS Author:Zaidi, STR (Dr Tabish Razi Zaidi)
UTAS Author:Wanandy, T (Mr Troy Wanandy)
UTAS Author:Castelino, RL (Dr Ronald Castelino)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:Patel, RP (Dr Rahul Patel)
ID Code:137518
Year Published:2020
Deposited By:Pharmacy
Deposited On:2020-02-18
Last Modified:2021-04-21

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