2023-07-05 16:07:00
(Vienna, 05 July 2023) Inflammation of the peritoneum (peritonitis) is a frequent and feared complication of dialysis in the peritoneum (peritoneal dialysis), a form of renal replacement therapy for independent use at home. The bacteria responsible for the life-threatening infections are becoming increasingly resistant to many antibiotics. A research team headed by Markus Zeitlinger, Head of the Department of Clinical Pharmacology at MedUni Vienna, has now successfully identified a new drug treatment option as part of a study. The research work was recently published in the journal “Clinical Microbiology and Infection”.
In order to arrive at their result, the researchers analyzed blood samples and dialysis fluid from patients undergoing peritoneal dialysis and also used computer-aided simulation models. It turned out that a comparatively low dosage of the active ingredient combination of ceftazidime and avibactam is sufficient to treat peritonitis. These substances belong to the group of antibiotics that are used in particular for certain (gram-negative) multi-resistant pathogens, such as those found in peritonitis. “In our study, we were able to show that the combination of these active ingredients in a dose of 760 or
190 mg is sufficient to treat peritonitis,” says lead author Valentin al Jalali from MedUni Vienna’s Department of Clinical Pharmacology. The correct, lowest possible dosage is of central importance, especially for dialysis patients, in order to avoid accumulation of the substances and the associated side effects.
In the course of renal replacement therapy using peritoneal dialysis (PD), around 30 percent of patients suffer from peritonitis. The infection is caused by bacteria that can get into the abdominal cavity via the dialysis catheter. Peritonitis can mean the exclusion from this type of dialysis and can become life-threatening if left untreated. That is why patients are instructed to pay attention to warning signals such as pain, nausea and vomiting, cloudiness of the dialysis fluid or fever.
Weak point for 50 years
In contrast to classic hemodialysis, PD uses the membrane of the peritoneum to filter metabolic products from the blood. The advantage over hemodialysis is the possibility of independent use in your own four walls, which patients perceive as a significant increase in their quality of life. Almost 50 years following the introduction of the method, the risk of infections is still considered a weak point of PD. “The results of our study might help get peritonitis under control even in patients with germs that are difficult to treat,” says study leader Markus Zeitlinger, head of MedUni Vienna’s Department of Clinical Pharmacology.
The high relevance of the research is underpinned by current developments: With the increasing number of patients with chronic kidney disease or loss of kidney function worldwide (5-8% per year), more and more patients need renal replacement therapy. Around three million people are affected by loss of kidney function. This trend is partly due to the increasing incidence of high blood pressure and diabetes, so-called lifestyle diseases that can severely damage the kidneys.
Publikation: Clinical Microbiology and Infection
Plasma and intraperitoneal pharmacokinetics of ceftazidime/avibactam in peritoneal dialysis patients
al Jalali, Valentin; Matzneller, Peter; Pham, Anh; van Os, Wisse; Wölfl-Duchek, Michael; Sanz Codina, Maria; Vychytil, Andreas; Rider, Birgit; Stimpfl, Thomas; Zeitler, Markus
doi.org/10.1016/j.cmi.2023.06.002
1688597226
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