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Published on: July 19, 2018
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Intraperitoneal Meropenem for Polymicrobial Peritoneal Dialysis-Related Peritonitis.
Caroline W H de Fijter1, Lily Jakulj2, Fariba Amiri2
1Internal Medicine/Nephrology, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands c.w.h.defijter@olvg.nl.
Summary
Daily intraperitoneal meropenem (125 mg/L) effectively treats peritoneal dialysis-related peritonitis caused by multidrug-resistant bacteria. Serial drug measurements confirmed safe dosing over 21 days.
Area of Science:
- Pharmacology
- Infectious Diseases
- Nephrology
Background:
- Rising prevalence of multidrug-resistant gram-negative bacteria necessitates effective antibiotic strategies.
- Carbapenems are increasingly utilized, yet pharmacokinetic data for meropenem in peritoneal dialysis (PD)-related peritonitis is limited.
Observation:
- This study investigated the pharmacokinetics of repeated intraperitoneal (IP) meropenem administration over 21 days.
- Treatment targeted polymicrobial, multidrug-resistant PD-related peritonitis.
Findings:
- A daily dose of 125 mg/L intraperitoneal meropenem administered in all PD fluid bags proved effective and safe.
- Serial drug concentration measurements up to 21 days indicated no instances of over- or underdosing.
Implications:
- Supports the use of 125 mg/L IP meropenem as a standard treatment for PD-associated peritonitis.
- Provides crucial pharmacokinetic data for optimizing meropenem dosing in PD patients with resistant infections.
- Highlights a safe and effective therapeutic option for a challenging clinical scenario.
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