The influence of different peritoneal dialysis fluids on the in vitro activity of ampicillin, daptomycin, and linezolid against Enterococcus faecalis

  • M. Kussmann
  • L. Schuster
  • M. Zeitlinger
  • P. Pichler
  • G. Reznicek
  • M. Wiesholzer
  • H. BurgmannEmail author
  • W. Poeppl
Original Article


Intraperitoneal administration of antibiotics is recommended for the treatment of peritoneal dialysis-related peritonitis. However, little data are available on a possible interference between peritoneal dialysis fluids and the activity of antimicrobial agents. Thus, the present in vitro study set out to investigate the influence of different peritoneal dialysis fluids on the antimicrobial activity of ampicillin, linezolid, and daptomycin against Enterococcus faecalis. Time–kill curves in four different peritoneal dialysis fluids were performed over 24 h with four different concentrations (1 × MIC, 4 × MIC, 8 × MIC, 30 × MIC) of each antibiotic evaluated. Cation-adjusted Mueller–Hinton broth was used as the comparator solution. All four peritoneal dialysis fluids evaluated had a bacteriostatic effect on the growth of Enterococcus faecalis. Compared to the cation-adjusted Mueller–Hinton broth comparator solution, the antimicrobial activity of all antibiotics tested was reduced. For ampicillin and linezolid, no activity was found in any peritoneal dialysis fluid, regardless of the concentration. Daptomycin demonstrated dose-dependent activity in all peritoneal dialysis fluids. Bactericidal activity was observed at the highest concentrations evaluated in Dianeal® PDG4 and Extraneal®, but not in concentrations lower than 30 × MIC and not in Nutrineal® PD4 and Physioneal® 40. The antimicrobial activity of ampicillin and linezolid is limited in peritoneal dialysis fluids in vitro. Daptomycin is highly effective in peritoneal dialysis fluids and might, thus, serve as an important treatment option in peritoneal dialysis-related peritonitis. Further studies are needed to evaluate the clinical impact of the present findings.


Antimicrobial Activity Ampicillin Peritoneal Dialysis Linezolid Daptomycin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank Heidelinde Schranz from the Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna for the valuable suggestions, excellent technical assistance, and support in the microbiological workup.


This work was supported by the Institute of Nephrology and Hematooncology of the Karl Landsteiner Society.

Conflict of interest

No conflicts of interest to declare.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • M. Kussmann
    • 1
  • L. Schuster
    • 1
  • M. Zeitlinger
    • 2
  • P. Pichler
    • 3
  • G. Reznicek
    • 4
  • M. Wiesholzer
    • 3
  • H. Burgmann
    • 1
    Email author
  • W. Poeppl
    • 1
    • 5
  1. 1.Department of Internal Medicine I, Division of Infectious Diseases and Tropical MedicineMedical University ViennaViennaAustria
  2. 2.Department of Clinical PharmacologyMedical University ViennaViennaAustria
  3. 3.Department of Internal Medicine I, University Hospital St. PoeltenKarl Landsteiner University of Health SciencesSt. PoeltenAustria
  4. 4.Department of PharmacognosyUniversity of ViennaViennaAustria
  5. 5.Department of DermatologyMedical University of ViennaViennaAustria

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