Stability of Vancomycin in Icodextrin Peritoneal Dialysis Solution

• Published in: The Annals of pharmacotherapy 2006-11, Vol.40 (11), p.1950-1954
• Main Authors: Nornoo, Adwoa O, Elwell, Rowland J
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Dialysis Solutions - chemistry; Dialysis Solutions - standards; Drug Stability; Emergency and intensive care: renal failure. Dialysis management; Glucans - chemistry; Glucans - standards; Glucose - chemistry; Glucose - standards; Intensive care medicine; Medical sciences; Peritoneal Dialysis - standards; Pharmacology. Drug treatments; Polyvinyl Chloride - chemistry; Polyvinyl Chloride - standards; Refrigeration - standards; Vancomycin - chemistry; Vancomycin - standards
• ISSN: 1060-0280; 1542-6270
• DOI: 10.1345/aph.1G321

Background: Icodextrin is a glucose polymer used as an alternative osmotic agent in peritoneal dialysis (PD) solutions. There are few data regarding the long-term stability of vancomycin in icodextrin PD solution. Objective: To determine the chemical stability of vancomycin in icodextrin PD solution in polyvinyl chloride containers over a 7 day period at 4, 24, and 37 °C. Methods: Study samples were prepared by adding 2000 mg vancomycin HCl to commercially available 2.0 L bags of icodextrin 7.5% PD solution. Nine bags were prepared and stored in the following conditions: 3 under refrigeration (5 °C), 3 at room temperature (24 °C), and 3 at body temperature (37 °C). Samples were withdrawn from each bag immediately after preparation and at predetermined intervals over the subsequent 7 days. Solutions were visually inspected for precipitation, cloudiness, or discoloration at each sampling interval. Total concentration of vancomycin in dialysate fluid was determined by high performance liquid chromatography. Results: Under refrigeration, a mean ± SD of 99.7% ± 0.5% of the initial vancomycin concentration remained at 168 hours (7 days). At room temperature, 97.5% ± 3.4% remained at 168 hours. At body temperature, 94.3% ± 3.9% remained at 24 hours. Stability was not assessed beyond these time points. Conclusions: Premixed vancomycin-icodextrin PD solutions, whether stored refrigerated or at room temperature, were found to be stable for up to 7 days. However, we recommend that these solutions be kept refrigerated whenever possible. Solutions stored at body temperature were stable for up to 24 hours, permitting the practice of prewarming solutions prior to administration.