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Intraperitoneal cefazolin and ceftazidime effects on human peritoneal mesothelial cell release of cancer antigen-125
Harold J Manley1, Rowland J Elwell, George R Bailie
1School of Pharmacy, University of Missouri, Kansas City, MO, USA. ManleyH@ACP.edu
Background:
Intraperitoneal (IP) cefazolin and ceftazidime are recommended as empiric treatment for peritoneal dialysis (PD)-associated peritonitis. Human peritoneal mesothelial cells (HPMCs) may be affected by high IP cefazolin and ceftazidime concentrations. Peritoneal dialysate cancer antigen-125 (CA-125) appearance rate can be used to measure HPMC damage.
Objective:
To determine whether IP cefazolin and ceftazidime increase peritoneal CA-125 appearance rate.
Methods:
The study consisted of 2 phases. In phase I, no antibiotic was administered, and in phase II, patients received IP cefazolin and ceftazidime (15 mg/kg rounded to nearest 100 mg). Phase II occurred immediately after phase I. Each phase used a 4-hour dwell time with 2 L of dextrose 2.5% dialysate. Dialysate samples were collected at 0, 0.5, 1, 2, and 4 hours during each phase. Samples were assayed for CA-125, and CA-125 appearance rate was calculated.
Results:
Thirteen patients were recruited (7 men; aged 44.0 +/-16.0 y). The mean +/- SD (range) CA-125 dialysate concentration after phases I and II were 6.6 +/- 3.7 U/mL (2.3-15.0) and 6.4 +/-3.8 U/mL (1.6-13.8), respectively (p = 0.46). The CA-125 appearance rate after phases I and II were 51.9 +/- 31.3 U/min/1.73 m(2) (13.8-113.0) and 50.5 +/- 32.9 U/min/1.73 m(2) (11.0-104.0), respectively (p = 0.57). The slopes of the regression lines of CA-125 appearance rate were not significantly different between phases I and II.
Conclusions:
These findings demonstrate that concurrently administered IP cefazolin and ceftazidime have no effect on HPMC release of CA-125 in non-infected PD patients.
Insights
Intraperitoneal cefazolin and ceftazidime, recommended for peritoneal dialysis peritonitis, do not affect human peritoneal mesothelial cell damage markers. This study found no significant difference in cancer antigen-125 appearance rates with or without these antibiotics.
Area of Science:
- Nephrology
- Pharmacology
Background:
- Intraperitoneal (IP) cefazolin and ceftazidime are standard empiric treatments for peritoneal dialysis (PD)-associated peritonitis.
- High concentrations of these antibiotics may impact human peritoneal mesothelial cells (HPMCs).
- Cancer antigen-125 (CA-125) appearance rate in dialysate is a marker for HPMC damage.
Purpose of the Study:
- To investigate the effect of IP cefazolin and ceftazidime on the CA-125 appearance rate in PD patients.
- To assess potential HPMC damage induced by these commonly used antibiotics.
Main Methods:
- A two-phase study was conducted on 13 PD patients.
- Phase I involved no antibiotic administration, while Phase II administered IP cefazolin and ceftazidime.
- Dialysate samples were collected over 4 hours with a 2.5% dextrose solution, and CA-125 appearance rate was calculated.
Main Results:
- Mean CA-125 dialysate concentrations and appearance rates were similar between Phase I and Phase II (p > 0.45).
- No significant difference was observed in the CA-125 appearance rate between the no-antibiotic and antibiotic phases.
- Regression analysis showed no significant difference in the slopes of CA-125 appearance rates between the two phases.
Conclusions:
- Concurrently administered IP cefazolin and ceftazidime do not affect HPMC release of CA-125 in non-infected PD patients.
- These findings suggest that the recommended doses of cefazolin and ceftazidime are safe regarding HPMC integrity in the absence of infection.
