The Stability and Compatibility of Clindamycin Phosphate and Gentamicin Sulfate Alone and in Combination in Peritoneal Dialysis Solution

The stability and compatibility of clindamycin phosphate and gentamicin sulfate alone and in combination in peritoneal dialysis solution was studied. Peritoneal dialysis solutions (Dianeal PD-2, Travenol) were prepared in triplicate containing either clindamycin 200 mcg/mL, gentamicin 10 mcg/mL, or a combination of the two. Drug concentrations were determined at intervals over a 96-h period. At each time, solutions were observed for visual incompatibility.

No significant changes in drug concentrations or visual characteristics were noted at the times and temperatures tested. We conclude that clindamycin phosphate and gentamicin sulfate are stable and compatible alone and in combination in the peritoneal dialysis solution tested.

Update on the challenging role of biofilms in peritoneal dialysis

Biofilms are commonly associated with an increased risk of patient infection. In peritoneal dialysis (PD), catheter associated infection, especially peritonitis, remains a clinically relevant problem. Although the presence of a biofilm is recognized in relapsing, repeat, and catheter-related peritonitis, it remains poorly characterized. In this review, an update on the role of biofilms in PD infections is presented. The emerging concept that host cells and tissue associated biofilms, in addition to the biofilms on the catheters themselves, contribute to the recalcitrance of infections is discussed. Furthermore, the evidence of biofilms on PD catheters, their developmental stages, and the possible influence of the PD environment are reviewed. The focus is given to ex vivo and in vitro studies that contribute to the elucidation of the interplay between host, microbial, and dialysis factors. The key issues that are still to be answered and the challenges to clinical practice are discussed.