Stability of Daptomycin in Dextrose and Icodextrin-Based Peritoneal Dialysis Solutions.

Area of Science:

• Nephrology
• Infectious Diseases
• Pharmacology

Background:

• Rising antibiotic resistance necessitates alternative treatments like daptomycin for peritoneal dialysis (PD) patients.
• Limited data exists on intraperitoneal daptomycin stability in common PD solutions, including icodextrin and higher dextrose concentrations.
• Understanding daptomycin stability is crucial for optimizing treatment protocols in PD.

Purpose of the Study:

• To determine the stability of intraperitoneal daptomycin in different PD solutions at varying concentrations.
• To establish the duration of daptomycin stability in standard PD bags under ambient conditions.
• To provide evidence-based guidance for the clinical use of intraperitoneal daptomycin.

Main Methods:

• Daptomycin stability was assessed in UltraBag dextrose 2.5%, UltraBag icodextrin 7.5%, and Stay-Safe Balance 2.3% PD bags.
• Two daptomycin concentrations (maintenance and loading levels) were prepared and stored at 25°C.
• Samples were collected at specified time points (up to 48 hours) and analyzed using high-performance liquid chromatography with diode array detector (HPLC-DAD).

Main Results:

• At maintenance concentration, daptomycin remained stable for 48 hours in dextrose 2.5% and 24 hours in icodextrin 7.5% and Balance 2.3%.
• At loading concentration, daptomycin stability lasted 12 hours in dextrose 2.5% and Balance 2.3%, and 48 hours in icodextrin 7.5%.
• Stability varied based on PD solution type and daptomycin concentration.

Conclusions:

• The study provides crucial stability data supporting the use of intraperitoneal daptomycin in diverse PD solutions.
• Findings guide the preparation and administration of daptomycin for peritonitis treatment in PD patients.
• Results can inform clinical practice, potentially enabling home-based nursing support for daptomycin administration.