Supplementary Material for: Stability and compatibility of amikacin and its combination antibiotics in 7.5% icodextrin peritoneal dialysis solution

Introduction: The study aimed to evaluate the stability and compatibility of diverse antibiotics in 7.5% icodextrin peritoneal dialysis (PD) solution, subjected to various temperatures over a span of 14 days period.
Methods: Antibiotics, namely amikacin, imipenem, ciprofloxacin, vancomycin and cefazolin, were incorporated into 7.5% icodextrin solution and subsequently stored at various temperature and period. The concentrations of these antibiotics were measured using high-performance liquid chromatography. Stability of antibiotics is defined as the remaining drug concentration > 90% of the initial one throughout the test period.
Results: Ciprofloxacin and amikacin were demonstrated stable for a period of 14 days in icodextrin solution across all tested temperatures. Amikacin retained over 90% of its initial concentration when combined with either vancomycin, cefazolin, or ciprofloxacin at various temperatures for 14 days. In combination with amikacin, ciprofloxacin maintained stability for 14 days at all tested temperatures, while vancomycin maintained stability for 14 days at both 4 ℃ and 25℃, and 7 days at 37℃. Cefazolin, however, only exhibited stability for 8 hours at 37°C and 7 days at both 4°C and 25°C. The stability of imipenem in icodextrin solution was notably low, remaining stable for a maximum 6 hours at 4°C.
Conclusion: Ciprofloxacin, amikacin, as well as combinations of amikacin and vancomycin, amikacin and cefazolin, amikacin and ciprofloxacin, can be added to icodextrin solution for treatment of peritoneal dialysis associated peritonitis because they maintain stability for a minimum of 7 days at the temperatures of 4℃ and 25℃, and 8 hours at 37℃.

引言：本研究旨在评估7.5%艾考糊精腹膜透析（PD）溶液中多种抗生素在不同温度下、为期14天的稳定性与配伍相容性。
方法：将阿米卡星、亚胺培南、环丙沙星、万古霉素及头孢唑林加入7.5%艾考糊精溶液中，随后置于不同温度条件下储存不同时长。采用高效液相色谱法（high-performance liquid chromatography）测定各抗生素的浓度。本研究中抗生素的稳定性定义为：整个试验周期内药物残留浓度不低于初始浓度的90%。
结果：环丙沙星与阿米卡星在艾考糊精溶液中，于所有测试温度下均可保持14天的稳定性。当与万古霉素、头孢唑林或环丙沙星配伍时，阿米卡星在不同温度下14天内的残留浓度均保持在初始浓度的90%以上。与阿米卡星联用时，环丙沙星在所有测试温度下均可维持14天稳定性；万古霉素在4℃与25℃下可保持14天稳定性，在37℃下仅可维持7天稳定性。而头孢唑林仅在37℃下可保持8小时稳定性，在4℃与25℃下仅可维持7天稳定性。亚胺培南在艾考糊精溶液中的稳定性极差，在4℃下最长仅可保持6小时的稳定性。
结论：环丙沙星、阿米卡星，以及阿米卡星与万古霉素、阿米卡星与头孢唑林、阿米卡星与环丙沙星的配伍组合，均可加入艾考糊精溶液用于治疗腹膜透析相关性腹膜炎，因为它们在4℃与25℃下至少可保持7天稳定性，在37℃下至少可保持8小时稳定性。