PloS one · 2025
Dialysate and plasma meropenem concentrations in continuous intraperitoneal regimen during peritoneal-dialysis-related peritonitis.
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Srithongkul Thatsaphan, Raksasuk Sukit, Techajongnumchai Bulaporn, Sritippayawan Suchai, Koomanachai Pornpan
Аннотация
BACKGROUND: A single dose of intraperitoneal (IP) meropenem is recommended for peritoneal-dialysis (PD)-related peritonitis stemming from extended-spectrum β-lactamase-producing organisms. However, data on IP meropenem is limited.
METHODS: This prospective, descriptive study was conducted to examine plasma and dialysate meropenem levels during continuous IP meropenem administration in five patients with PD-related peritonitis. All patients received an IP meropenem loading dose of 500 mg, followed by IP meropenem at 125 mg/L, with four exchanges daily. The plasma and dialysate meropenem concentrations were measured at specified intervals for a 24-hour period utilizing a high-performance, liquid chromatography method.
RESULTS: Five patients with PD related peritonitis were studied. The mean-maximum dialysate and plasma meropenem levels were 158.1 mg/L (standard deviation [SD] ± 62.9) and 29.4 mg/L (SD ± 15.9), respectively. The mean dialysate meropenem level was at its minimum of 32.6 mg/L (SD ± 19.1) at 24 hours. Throughout the period, the dialysate meropenem levels exceeded the minimal inhibitory concentration of the pathogenic resistance organism (> 8 mg/L). Four patients responded to the treatment, whereas one developed treatment failure from fungal peritonitis.
CONCLUSION: An IP meropenem loading of 500 mg, followed by 125 mg/L every 6 hours, provided an adequate dialysate meropenem concentration and is an effective treatment for PD related peritonitis.
TRIAL REGISTRATION: Thai Clinical Trials Registry (TCTR20191121002) with date of first registration at 21/11/2019 (retrospectively registered).
METHODS: This prospective, descriptive study was conducted to examine plasma and dialysate meropenem levels during continuous IP meropenem administration in five patients with PD-related peritonitis. All patients received an IP meropenem loading dose of 500 mg, followed by IP meropenem at 125 mg/L, with four exchanges daily. The plasma and dialysate meropenem concentrations were measured at specified intervals for a 24-hour period utilizing a high-performance, liquid chromatography method.
RESULTS: Five patients with PD related peritonitis were studied. The mean-maximum dialysate and plasma meropenem levels were 158.1 mg/L (standard deviation [SD] ± 62.9) and 29.4 mg/L (SD ± 15.9), respectively. The mean dialysate meropenem level was at its minimum of 32.6 mg/L (SD ± 19.1) at 24 hours. Throughout the period, the dialysate meropenem levels exceeded the minimal inhibitory concentration of the pathogenic resistance organism (> 8 mg/L). Four patients responded to the treatment, whereas one developed treatment failure from fungal peritonitis.
CONCLUSION: An IP meropenem loading of 500 mg, followed by 125 mg/L every 6 hours, provided an adequate dialysate meropenem concentration and is an effective treatment for PD related peritonitis.
TRIAL REGISTRATION: Thai Clinical Trials Registry (TCTR20191121002) with date of first registration at 21/11/2019 (retrospectively registered).