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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.

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|September 24, 2016
PubMed

Insights

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.
Keywords:
CarbapenemsPD-related peritonitismeropenem

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