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Clinical Trial Details — Status: Enrolling by invitation

Administrative data

NCT number NCT04367974
Other study ID # WZhu
Secondary ID
Status Enrolling by invitation
Phase
First received
Last updated
Start date June 1, 2020
Est. completion date May 1, 2022

Study information

Verified date April 2020
Source Fifth Affiliated Hospital, Sun Yat-Sen University
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Peritoneal dialysis-related peritonitis is a common complication of peritoneal dialysis, which is the main cause of transfer from peritoneal dialysis to hemodialysis. Guidelines for International Society for peritoneal dialysis(ISPD)published in 2016 recommend that timely and adequate use of antibiotics is the most important part of treatment. Empiric treatment should be initiated as soon as possible after obtaining microbiological specimens,then adjust the antibiotics according to culture results and drug sensitivity of bacteria. Intraperitoneal antibiotic can ensure antibiotic concentrations at the local sites of the infection are maximized,however, in patients with renal failure, the investigators should pay attention to the nephrotoxicity caused by the reduction of renal excretion,being guided by Pharmacokinetic/ Pharmacodynamic Principle on antibiotic can develop dosing recommendations to optimize antibiotic efficacy and minimize toxicity. In this study, the investigators aim to detect the concentration of ceftazidime and cefazolin in CAPD patients,so as to analyze the pharmacokinetics parameters and evaluate the rationality of the treatment.


Description:

The dose of cefazolin and Ceftazidime co-administered were 20 mg /kg,they were given intraperitoneal twice daily in the first bag and the fourth bag for 5 days,and given 1g once daily in the fourth bag for 9 days. Total treatment duration was 2 weeks.

At least 1-mL serum and 5-mL dialysate samples were collected at 1, 2, 4, 6, 10, 14 days after complete instillation of the first dialysis bag containing antibiotic into the peritoneal cavity. The samples were then centrifuged at 3,000 rpm, all study samples were stored frozen (-80℃) within 1 hour after collection.


Recruitment information / eligibility

Status Enrolling by invitation
Enrollment 20
Est. completion date May 1, 2022
Est. primary completion date May 1, 2021
Accepts healthy volunteers No
Gender All
Age group 15 Years to 70 Years
Eligibility Inclusion Criteria:

Maintained on continuous ambulatory PD (CAPD) for at least 1 month,all patients received 4 exchanges per day with dialysate volumes of 2 L per exchange.

1. The diagnostic criteria for CAPD-related peritonitis are as follows:

The dialysate fluid appears cloudy and accord with the following peritonitis diagnostic criteria: (with the following two can be diagnosed) A. Clinical manifestations of peritoneics, such as abdominal pain and/or turbid flow of fluid from peritoneal dialysis; B. Perital dialysis discharge of liquid pathogen culture positive. C. The white blood cell count of perital dialysis outflow liquid were more than 0. 1 x 10 x 9/L, and the percentage of polymorphic nucleocells is more than 50% (peritoneal dialysis fluid remains in the abdominal cavity for at least 2 hours for more than 2 hours);

2. No urine (less than 100ml per 24h).

3. Age range form 15 years old to 70 years old, gender is not limited;

4. Understand and agree to this clinical trial study.

Exclusion Criteria:

1. With a clear history of cephalosporine drug allergy or hypersensitivity;

2. Received antibiotic treatment within 1 week prior to entering the study;

3. Pregnant and lactating women;

4. Sepsis;

5. Patients with celiac malignancy;

6. The patient is unable to cooperate or unwilling to accept the test.

Study Design


Related Conditions & MeSH terms


Locations

Country Name City State
China the fifth affiliated hospital of SUN YAT-SEN university Zhuhai Guangdong

Sponsors (1)

Lead Sponsor Collaborator
Fifth Affiliated Hospital, Sun Yat-Sen University

Country where clinical trial is conducted

China, 

References & Publications (9)

Booranalertpaisarn V, Eiam-Ong S, Wittayalertpanya S, Kanjanabutr T, Na Ayudhya DP. Pharmacokinetics of ceftazidime in CAPD-related peritonitis. Perit Dial Int. 2003 Nov-Dec;23(6):574-9. — View Citation

Cardone KE, Grabe DW, Zasowski EJ, Lodise TP. Reevaluation of ceftazidime dosing recommendations in patients on continuous ambulatory peritoneal dialysis. Antimicrob Agents Chemother. 2014;58(1):19-26. doi: 10.1128/AAC.00873-13. Epub 2013 Oct 14. — View Citation

Grabe DW, Bailie GR, Eisele G, Frye RF. Pharmacokinetics of intermittent intraperitoneal ceftazidime. Am J Kidney Dis. 1999 Jan;33(1):111-7. — View Citation

Htay H, Cho Y, Pascoe EM, Hawley C, Clayton PA, Borlace M, Badve SV, Sud K, Boudville N, McDonald SP, Johnson DW. Outcomes of Acinetobacter Peritonitis in Peritoneal Dialysis Patients: A Multicenter Registry Analysis. Perit Dial Int. 2018 Jul-Aug;38(4):25 — View Citation

Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, Fish DN, Goffin E, Kim YL, Salzer W, Struijk DG, Teitelbaum I, Johnson DW. ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. Perit Dial Int. 2016 Sep 10;36(5):481-508 — View Citation

Manley HJ, Bailie GR. Treatment of peritonitis in APD: pharmacokinetic principles. Semin Dial. 2002 Nov-Dec;15(6):418-21. Review. — View Citation

McKinnon PS, Paladino JA, Schentag JJ. Evaluation of area under the inhibitory curve (AUIC) and time above the minimum inhibitory concentration (T>MIC) as predictors of outcome for cefepime and ceftazidime in serious bacterial infections. Int J Antimicrob — View Citation

Ranganathan D, Varghese JM, Fassett RG, Lipman J, D'Intini V, Healy H, Roberts JA. Optimising intraperitoneal gentamicin dosing in peritoneal dialysis patients with peritonitis (GIPD) study. BMC Nephrol. 2009 Dec 16;10:42. doi: 10.1186/1471-2369-10-42. — View Citation

Tosukhowong T, Eiam-Ong S, Thamutok K, Wittayalertpanya S, Na Ayudhya DP. Pharmacokinetics of intraperitoneal cefazolin and gentamicin in empiric therapy of peritonitis in continuous ambulatory peritoneal dialysis patients. Perit Dial Int. 2001 Nov-Dec;21 — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary concentration of ceftazidime and cefazolin Cefazolin and ceftazidime were measured by LC-MS. The lower limit of quantitation for cefazolin and ceftazidime was 0.05 -1.0 µg /ml. 2 weeks