Evidence map›Paper›PMID 26764340›Full record

Observational studyPeritoneal dialysis international : journal of the International Society for Peritoneal Dialysis

Pharmacokinetics of Intraperitoneal Cefalothin and Cefazolin in Patients Being Treated for Peritoneal Dialysis-Associated Peritonitis.

Darren M Roberts, Dwarakanathan Ranganathan, Steven C Wallis, Julie M Varghese, Adrian Kark, Jeffrey Lipman, Jason A Roberts

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Darren M RobertsBurns, Trauma & Critical Care Research Centre, School of Medicine, The University of Queensland, Butterfield Street, Herston, Queensland, Australia Medical School, Australian National University, Acton, ACT, Australia darren.roberts@uq.edu.au.
Dwarakanathan RanganathanDepartment of Renal Medicine, Royal Brisbane & Women's Hospital, Butterfield Street, Herston, Queensland, Australia.
Steven C WallisBurns, Trauma & Critical Care Research Centre, School of Medicine, The University of Queensland, Butterfield Street, Herston, Queensland, Australia.
Julie M VargheseBurns, Trauma & Critical Care Research Centre, School of Medicine, The University of Queensland, Butterfield Street, Herston, Queensland, Australia.
Adrian KarkDepartment of Renal Medicine, Royal Brisbane & Women's Hospital, Butterfield Street, Herston, Queensland, Australia.
Jeffrey LipmanBurns, Trauma & Critical Care Research Centre, School of Medicine, The University of Queensland, Butterfield Street, Herston, Queensland, Australia Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Butterfield Street, Herston, Queensland, Australia.
Jason A RobertsBurns, Trauma & Critical Care Research Centre, School of Medicine, The University of Queensland, Butterfield Street, Herston, Queensland, Australia Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Butterfield Street, Herston, Queensland, Australia Pharmacy Department, Royal Brisbane & Women's Hospital, Butterfield Street, Herston, Queensland, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

unlabelled♦

backgroundThe standard treatment of peritoneal dialysis (PD)-associated peritonitis (PD-peritonitis) is intraperitoneal (IP) administration of antibiotics. Only limited data on the pharmacokinetics and appropriateness of contemporary dose recommendations of IP cefalothin and cefazolin exist. The aim of this study was to describe the pharmacokinetics of IP cefalothin and cefazolin in patients treated for PD-peritonitis. ♦

methodsAs per international guidelines, IP cefalothin or cefazolin 15 mg/kg once daily was dosed with gentamicin in a 6-hour dwell to patients with PD-peritonitis during routine care. Serial plasma and PD effluent samples were collected over the first 24 hours of therapy. Antibiotic concentrations were quantified using a validated chromatographic method with pharmacokinetic analysis performed using a non-compartmental approach. ♦

resultsNineteen patients were included (cefalothin n = 8, cefazolin n = 11). The median bioavailability for both antibiotics exceeded 92%, but other pharmacokinetic parameters varied markedly between antibiotics. Both antibiotics achieved high PD effluent concentrations throughout the antibiotic dwell. Cefazolin had a smaller volume of distribution compared with cefalothin (14 vs 40 L, p = 0.003). The median trough total plasma antibiotic concentration for cefazolin and cefalothin during the dwell differed (plasma 56 vs 13 mg/L, p < 0.0001) despite a similar concentration in PD effluent (37 vs 38 mg/L, p = 0.58). Lower antibiotic concentrations were noted during PD dwells not containing antibiotic, particularly cefalothin, which was frequently undetectable in plasma and PD effluent. The median duration that the unbound antibiotic concentration was above the minimum inhibitory concentration (MIC) was approximately 13% (plasma) and 25% (IP) for cefalothin, and 100% (plasma and IP) for cefazolin, of the dosing interval. ♦

conclusionsWhen IP cefalothin or cefazolin is allowed to dwell for 6 hours, sufficient PD effluent concentrations are present for common pathogens during this time. However, with once-daily IP dosing, in contrast to cefazolin, there is a risk of subtherapeutic plasma and PD effluent cefalothin concentrations, so more frequent dosing may be required.

Indexed as

AdultAgedAnti-Bacterial AgentsBiological AvailabilityCefazolinCephalothinFemaleGentamicinsHumansKidney Failure, ChronicMaleMiddle AgedPeritoneal DialysisPeritonitisProspective StudiesAnti-Bacterial AgentsCefazolinCephalothinGentamicinsAntibioticcephalosporindialysisinfectionperitonitispharmacokinetics

Identifiers

PMID26764340
PMCPMC4934436

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.