Intraperitoneal Cefazolin and Ceftazidime Effects on Human Peritoneal Mesothelial Cell Release of Cancer Antigen–125

Abstract

BACKGROUND Intraperitoneal (IP) cefazolin and ceftazidime are recommended as empiric treatment for peritoneal dialysis (PD)–associated peritonitis. Human peritoneal mesothelial cells (HPMCs) may be affected by high IP cefazolin and ceftazidime concentrations. Peritoneal dialysate cancer antigen–125 (CA-125) appearance rate can be used to measure HPMC damage. OBJECTIVE To determine whether IP cefazolin and ceftazidime increase peritoneal CA-125 appearance rate. METHODS The study consisted of 2 phases. In phase I, no antibiotic was administered, and in phase II, patients received IP cefazolin and ceftazidime (15 mg/kg rounded to nearest 100 mg). Phase II occurred immediately after phase I. Each phase used a 4-hour dwell time with 2 L of dextrose 2.5% dialysate. Dialysate samples were collected at 0, 0.5, 1, 2, and 4 hours during each phase. Samples were assayed for CA-125, and CA-125 appearance rate was calculated. RESULTS Thirteen patients were recruited (7 men; aged 44.0 ± 16.0 y). The mean ± SD (range) CA-125 dialysate concentration after phases I and II were 6.6 ± 3.7 U/mL (2.3–15.0) and 6.4 ± 3.8 U/mL (1.6–13.8), respectively (p = 0.46). The CA-125 appearance rate after phases I and II were 51.9 ± 31.3 U/min/1.73 m2 (13.8–113.0) and 50.5 ± 32.9 U/min/1.73 m2 (11.0–104.0), respectively (p = 0.57). The slopes of the regression lines of CA-125 appearance rate were not significantly different between phases I and II. CONCLUSIONS These findings demonstrate that concurrently administered IP cefazolin and ceftazidime have no effect on HPMC release of CA-125 in non-infected PD patients.