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Stability of cotrimoxazole in peritoneal dialysis fluid

S E Holmes1, S Aldous

  • 1School of Pharmacy, University of Tasmania, Hobart, Australia.

Insights

Cotrimoxazole stability in peritoneal dialysis fluid is container-dependent. Trimethoprim is stable in glass, while sulphamethoxazole degrades rapidly in both plastic and glass containers, limiting shelf-life to 12 hours.

Area of Science:

  • Pharmaceutical Sciences
  • Clinical Pharmacy
  • Drug Stability Studies

Background:

  • Cotrimoxazole, a combination of trimethoprim and sulphamethoxazole, is an important antibiotic.
  • Peritoneal dialysis (PD) solutions are used for renal replacement therapy.
  • The stability of antibiotic admixtures in PD fluids is crucial for effective treatment.

Purpose of the Study:

  • To evaluate the stability of trimethoprim and sulphamethoxazole in peritoneal dialysis fluid.
  • To assess the impact of storage containers (polyvinyl chloride bags vs. glass ampoules) on drug stability.
  • To determine the shelf-life of cotrimoxazole admixtures in PD fluid at room temperature.

Main Methods:

  • Preparation of cotrimoxazole admixtures in peritoneal dialysis fluid.
  • Storage of admixtures in PVC bags and glass ampoules at room temperature.
  • Stability testing over nine days using High-Performance Liquid Chromatography (HPLC).

Main Results:

  • Trimethoprim showed significant loss (>10%) within three days in PVC bags, but remained stable in glass ampoules for nine days.
  • Sulphamethoxazole loss (>10%) occurred within two days in both container types, with rapid degradation observed within 12 hours in one plastic admixture.
  • HPLC analysis revealed a time-dependent appearance of an additional peak, indicating chemical decomposition of sulphamethoxazole.

Conclusions:

  • The stability of cotrimoxazole in PD fluid is influenced by the storage container, particularly for trimethoprim.
  • Sulphamethoxazole is unstable in PD fluid, undergoing chemical decomposition.
  • The overall shelf-life of cotrimoxazole admixtures in PD fluid at room temperature is limited to 12 hours due to sulphamethoxazole instability.

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