Stability of amphotericin B in CAPD fluid

Area of Science:

• Pharmacology
• Nephrology
• Clinical Pharmacy

Background:

• Amphotericin B is the preferred treatment for fungal peritonitis in continuous ambulatory peritoneal dialysis (CAPD).
• CAPD fluids contain anions (chloride, lactate) that may cause incompatibility with amphotericin B.
• Understanding amphotericin B stability in CAPD solutions is vital for effective treatment.

Purpose of the Study:

• To evaluate the physical and chemical compatibility of amphotericin B with common CAPD components.
• To determine the stability of amphotericin B in dextrose 5%, Dianeal 1.36% CAPD fluid, and peritoneal effluent.

Main Methods:

• Amphotericin B solutions at 1, 2, and 5 mg/L were prepared.
• Compatibility was assessed in dextrose 5%, Dianeal 1.36% CAPD fluid, and peritoneal effluent.
• Incubation at 37°C for 6 hours followed by analysis of decomposition.

Main Results:

• Amphotericin B demonstrated highest stability in Dianeal 1.36% CAPD fluid across all tested concentrations.
• Degradation rate in dextrose 5% and effluent was concentration-dependent, decreasing with higher amphotericin B concentrations.
• No significant decomposition of amphotericin B was observed in Dianeal CAPD fluid after 6 hours, while 12-18% decomposition occurred in effluent.

Conclusions:

• Dianeal 1.36% CAPD fluid provides a stable medium for amphotericin B administration.
• Concentration influences amphotericin B degradation in dextrose and effluent, necessitating careful dosing.
• No physical incompatibilities were noted, supporting its use in CAPD fungal peritonitis.