1887

Abstract

Summary

Fusidic acid, an antimicrobial agent with activity against coagulase-positive and coagulase-negative staphylococci, has considerable potential for the management of staphylococcal peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD). Whether fusidic acid reaches therapeutic levels in the dialysate once therapeutic serum levels have been achieved is not known. An animal model of CAPD that reproduced essential features of the clinical procedure was used to investigate this issue. Although oral administration was the preferred route, fusidic acid is not absorbed from the gastrointestinal tract of laboratory rats, and a subcutaneous injection of diethanolamine fusidate was used to achieve serum levels of the agent equivalent to those achieved clinically in man. In this model, fusidic acid concentrations up to 28 times the MIC for staphylococci were found in the dialysate when therapeutic levels of the agent were reached in the serum. The data provide support for continued experimental and clinical evaluation of the role of fusidic acid in CAPD-associated peritonitis.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/00222615-36-2-71
1992-02-01
2024-04-19
Loading full text...

Full text loading...

/deliver/fulltext/jmm/36/2/medmicro-36-2-71.html?itemId=/content/journal/jmm/10.1099/00222615-36-2-71&mimeType=html&fmt=ahah

References

  1. Heaton A., Rodger R. S. C., Sellars L. Continuous ambulatory peritoneal dialysis after the honeymoon: review of experience in Newcastle 1979-84. Br Med J 1986; 293:938–941
    [Google Scholar]
  2. Nissenson A. R., Gentile D. E., Soderblom R. E., Oliver D. F., Brax C. the Medical Review Board, NCC #4, Los Angeles, California. Morbidity and mortality of continuous ambulatory peritoneal dialysis: regional experience and longterm prospects. Am J Kidney Dis 1986; 7:229–234
    [Google Scholar]
  3. Glew R. H., Pavuk R. A., Shuster A., Alfred H. J. Vancomycin pharmacokinetics in patients undergoing chronic intermittent peritoneal dialysis. Int J Clin Pharmacol Ther Toxicol 1982; 20:559–563
    [Google Scholar]
  4. Somani P., Shapiro R. S., Stockard H., Higgins J. T. Unidirectional absorption of gentamicin from the peritoneum during continuous ambulatory peritoneal dialysis. Clin Pharm Ther 1982; 32:113–121
    [Google Scholar]
  5. Blevins R. D., Halstenson C. E., Salem N. G., Matzke G. R. Phar macokinetics of vancomycin in patients undergoing continuous ambulatory peritoneal dialysis. Antimicrob Agents Chemother 1984; 25:603–606
    [Google Scholar]
  6. Boeschoten E. W., Rietra P. J. G. M., Krediet R. T., Visser M. J., Arisz L. CAPD peritonitis: a prospective randomized trial of oral versus intraperitoneal treatment with cephradine. J Antimicrob Chemother 1985; 16:789–797
    [Google Scholar]
  7. Nolph K. D., Cutler S. J., Steinberg S. M., Novak J. W. Continuous ambulatory peritoneal dialysis in the United States: a three-year study. Kidney Int 1985; 28:198–205
    [Google Scholar]
  8. Fenton S. S. A. The University of Toronto Collaborative Dialysis Group. Peritonitis related deaths among CAPD patients. Peritoneal Dialysis Bulletin 1983; 3: Suppl 9S–11S
    [Google Scholar]
  9. Taylor G., Bloor K. Antistaphylococcal activity of fucidin. Lancet 1962; 1:935–937
    [Google Scholar]
  10. Crosbie R. B. Treatment of staphylococcal infections with “fucidin”. Br Med J 1963; 1:788–794
    [Google Scholar]
  11. Reeves D. S. Review—The pharmacokinetics of fusidic acid. J Antimicrob Chemother 1987; 20:467–476
    [Google Scholar]
  12. Saggers B. A., Lawson D. In vivo penetration of antibiotics into sputum in cystic fibrosis. Arch Dis Child 1968; 43:404–409
    [Google Scholar]
  13. Sattar M. A., Barrett S. P., Cawley M. I. D. Concentrations of some antibiotics in synovial fluid after oral administration, with special reference to antistaphylococcal activity. Ann Rheum Dis 1983; 42:67–74
    [Google Scholar]
  14. Saggers B. A., Lawson D. Some observations on the penetration of antibiotics through mucus in vitro. J Clin Pathol 1966; 19:313–317
    [Google Scholar]
  15. Chater E. H., Flynn J., Wilson A. L. Fucidin levels in osteomyelitis. J Irish Med Assoc 1972; 65:506–508
    [Google Scholar]
  16. Guttler F., Tybring L. Interaction of albumin and fusidic acid. Br J Pharmacol 1971; 43:151–160
    [Google Scholar]
  17. McIntosh M. E., Smith W. G. J., Junor B. J. R., Forrest G., Brodie M. J. Increased peritoneal permeability in patients with peritonitis undergoing continuous ambulatory peritoneal dialysis. Eur J Clin Pharmacol 1985; 28:187–191
    [Google Scholar]
  18. Walshe J. J., Morse G. D. Infectious complications of peritoneal dialysis. In Nissenson A. R. (eds) Clinical dialysis 2nd edn Norwalk: CT, Appleton & Lange; 1990301–318
    [Google Scholar]
  19. Rubinstein E., Adam D., Moellering R., Waldvogel F. International symposium on new quinolones. Rev Infect Dis 1988; 10: Suppl1 S1–S271
    [Google Scholar]
  20. Rose T. F., Ellis-Pegler R., Collins J., Small M. Oral pefloxacin mesylate in the treatment of continuous ambulatory peritoneal dialysis associated peritonitis: an open noncomparative study. J Antimicrob Chemother 1990; 25:853–859
    [Google Scholar]
  21. MacGowan A. P., Greig M. A., Andrews J. M., Reeves D. S., Wise R. Pharmacokinetics and tolerance of a new film-coated tablet of sodium fusidate administered as a single oral dose to healthy volunteers. J Antimicrob Chemother 1989; 23:409–415
    [Google Scholar]
  22. Verbist L. The antimicrobial activity of fusidic acid. J Antimicrob Chemother 1990; 25: Suppl B1–5
    [Google Scholar]
  23. Jensen K., Lassen H. C. A. Combined treatment with antibacterial chemotherapeutical agents in staphylococcal infections. Q J Med 1969; 38:91–106
    [Google Scholar]
  24. Rowling D. E. Further experience in the management of chronic osteomyelitis. J Bone Joint Surg 1970; 52B:302–307
    [Google Scholar]
  25. Cartwright R. Y., Hall G. H. Management of shunt infection. Br Med J 1972; 4:46
    [Google Scholar]
  26. Liddy N. Intravenous fusidic acid in the newborn. Lancet 1973; 1:621
    [Google Scholar]
  27. Kanski J. J. Treatment of late endophthalmitis associated with filtering blebs. Arch Ophthalmol 1974; 91:339–343
    [Google Scholar]
  28. Deodhar S. D., Russell F., Dick W. C., Nuki G., Buchanan W. W. Penetration of sodium fusidate (fucidin) in the synovial cavity. Scand J Rheumatol 1972; 1:33–39
    [Google Scholar]
  29. de Louvois J., Gortvai P., Hurley R. Antibiotic treatment of abscesses of the central nervous system. Br Med J 1977; 2:985–987
    [Google Scholar]
  30. Evans R. C., Holmes C. J. Effect of vancomycin hydrochloride on Staphylococcus epidermidis biofilm associated with silicone elastomer. Antimicrob Agents Chemother 1987; 31:889–894
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/00222615-36-2-71
Loading
/content/journal/jmm/10.1099/00222615-36-2-71
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error