Intraperitoneal Meropenem for Polymicrobial Peritoneal Dialysis-Related Peritonitis

Abstract

With the current rise in multiresistant gram-negative bacteria, carbapenems are more frequently used. Surprisingly, limited data exist on the pharmacokinetics of meropenem in peritoneal dialysis (PD)-related peritonitis. We report on the pharmacokinetics of repeated intraperitoneal (IP) meropenem during 21 days as treatment for polymicrobial multiresistent PD-related peritonitis.Our current report supports daily doses of 125 mg/L intraperitoneal meropenem in all bags as an effective and safe modality in the treatment of PD-associated peritonitis with multiresistant microorganisms. No signs of over- or underdosing were found based on serial drug concentration measurements at fixed time points up to 21 days.

Keywords: Carbapenems; PD-related peritonitis; meropenem.

Figure 1 —

Concentrations of meropenem (mg/L) in plasma (circles) and peritoneal fluid (squares) during continuous intraperitoneal (i.p.) treatment with meropenem 125 mg/L. Plasma concentrations were measured at 1, 2, 4, 24, 144, 312, and 480 hours after administration of the first dose of IP meropenem. Concentrations in peritoneal fluid were measured at 0, 1, 2, and 4 hours after administration of the first dose.