{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T06:10:53Z","timestamp":1779430253698,"version":"3.53.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Peritoneal dialysis (PD) enables intraperitoneal antibiotic delivery, but the efficacy of ceftazidime\/avibactam (CAZ\/AVI) in PD fluid (PDF) is not well-characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the in vitro activity of ceftazidime\/avibactam against Pseudomonas aeruginosa in fresh PDF and patient-derived dialysate at isolate-specific MIC levels and at a clinically measured intraperitoneal peak concentration (Cmax).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MICs were determined for P. aeruginosa ATCC 27583 and nine clinical isolates using broth microdilution in CAMHB. Two isolates (123\/19, 174\/19) underwent time-kill experiments at MIC (8\u201316\u2005\u00b5g\/mL) and maximum peritoneal concentration (Cmax 64\u2005\u00b5g\/mL), with avibactam fixed at 4\u2005\u00b5g\/mL. Bacterial counts were evaluated over 24\u2005h in CAMHB, icodextrin-containing PDF, and patient-derived dialysate (n\u200a=\u200a4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Isolates showed variable growth. Ceftazidime\/avibactam was bactericidal in CAMHB but only bacteriostatic in PDF and patient-derived dialysate (\u00b11 log10\u2005cfu\/mL reduction at 8\u2005h). No further reduction occurred at 24\u2005h, even at Cmax.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reduced bacterial growth in PDF is associated with diminished ceftazidime\/avibactam activity, yielding primarily bacteriostatic effects. Single-dose intraperitoneal administration may be insufficient to eradicate P. aeruginosa, as Cmax concentrations failed to achieve \u22653 log10\u2005cfu\/mL reduction in vitro. These findings highlight potential limitations of ceftazidime\/avibactam in PD-related infections and might guide future dosing strategies research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag185","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T12:04:16Z","timestamp":1778760256000},"source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of ceftazidime\/avibactam against 10 clinical isolates of\n                    <i>Pseudomonas aeruginosa<\/i>\n                    in icodextrin-based peritoneal dialysis solution and patient-derived dialysate"],"prefix":"10.1093","volume":"81","author":[{"given":"Stephanie","family":"Supparitsch","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna , Waehringer Guertel 18-20, Vienna 1090 ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Vychytil","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Dialysis, Medical University of Vienna , Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Zeitlinger","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna , Waehringer Guertel 18-20, Vienna 1090 ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8238-8488","authenticated-orcid":false,"given":"Alina","family":"Nussbaumer-Pr\u00f6ll","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna , Waehringer Guertel 18-20, Vienna 1090 ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"2026052202033990400_dkag185-B1","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1016\/S0140-6736(98)09410-0","article-title":"Peritoneal dialysis","volume":"353","author":"Gokal","year":"1999","journal-title":"The Lancet"},{"key":"2026052202033990400_dkag185-B2","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1053\/j.ajkd.2019.10.004","article-title":"Icodextrin versus glucose solutions for the once-daily long dwell in peritoneal dialysis: an enriched systematic review and meta-analysis of randomized controlled trials","volume":"75","author":"Goossen","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"2026052202033990400_dkag185-B3","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1007\/s11560-016-0112-z","article-title":"Peritonealdialysel\u00f6sungen","volume":"12","author":"Vychytil","year":"2016","journal-title":"Nephrologe"},{"key":"2026052202033990400_dkag185-B4","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.2215\/CJN.14631218","article-title":"Peritoneal dialysis\u2013associated peritonitis","volume":"14","author":"Szeto","year":"2019","journal-title":"Clin J Am Soc Nephrol"},{"key":"2026052202033990400_dkag185-B5","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1177\/08968608211018949","article-title":"Impact of peritoneal dialysis-related peritonitis on PD discontinuation and mortality: a population-based national cohort study","volume":"42","author":"Chung","year":"2022","journal-title":"Perit Dial Int"},{"key":"2026052202033990400_dkag185-B6","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1177\/089686080502500302","article-title":"Fungal peritonitis in peritoneal dialysis patients","volume":"25","author":"Prasad","year":"2005","journal-title":"Perit Dial Int"},{"key":"2026052202033990400_dkag185-B7","doi-asserted-by":"publisher","first-page":"13","DOI":"10.2147\/hmer.s164250","article-title":"Spontaneous bacterial peritonitis in patients with cirrhosis: incidence, outcomes, and treatment strategies","volume":"11","author":"Marciano","year":"2019","journal-title":"Hepat Med"},{"key":"2026052202033990400_dkag185-B8","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.3390\/antibiotics10091126","article-title":"Review of ceftazidime-avibactam for the treatment of infections caused by pseudomonas aeruginosa","volume":"10","author":"Daikos","year":"2021","journal-title":"Antibiotics (Basel)"},{"key":"2026052202033990400_dkag185-B9","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.biotechadv.2018.11.013","article-title":"Antibiotic resistance in Pseudomonas aeruginosa: mechanisms and alternative therapeutic strategies","volume":"37","author":"Pang","year":"2019","journal-title":"Biotechnol Adv"},{"key":"2026052202033990400_dkag185-B10","doi-asserted-by":"publisher","first-page":"688","DOI":"10.3747\/pdi.2010.00178","article-title":"Impact of various peritoneal dialysis solutions on the growth of common bacterial and yeast pathogens","volume":"31","author":"Tobudic","year":"2011","journal-title":"Perit Dial Int"},{"key":"2026052202033990400_dkag185-B11","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1007\/s10096-018-3221-y","article-title":"Influence of different peritoneal dialysis fluids on the in vitro activity of fosfomycin against Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa","volume":"37","author":"Kussmann","year":"2018","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2026052202033990400_dkag185-B12","doi-asserted-by":"publisher","first-page":"435","DOI":"10.4239\/wjd.v11.i10.435","article-title":"Comparison of clinical features and outcomes in peritoneal dialysis-associated peritonitis patients with and without diabetes: a multicenter retrospective cohort study","volume":"11","author":"Meng","year":"2020","journal-title":"World J Diabetes"},{"key":"2026052202033990400_dkag185-B13","doi-asserted-by":"publisher","first-page":"12478","DOI":"10.3390\/molecules171112478","article-title":"Development of new drugs for an old target - the penicillin binding proteins","volume":"17","author":"Zervosen","year":"2012","journal-title":"Molecules"},{"key":"2026052202033990400_dkag185-B14","doi-asserted-by":"publisher","first-page":"421","DOI":"10.3747\/pdi.2015.00062","article-title":"Stability of antibiotics for intraperitoneal administration in extraneal 7.5% icodextrin peritoneal dialysis bags (STAB study)","volume":"36","author":"Ranganathan","year":"2016","journal-title":"Perit Dial Int"},{"key":"2026052202033990400_dkag185-B15","doi-asserted-by":"publisher","first-page":"1196.e1","DOI":"10.1016\/j.cmi.2023.06.002","article-title":"Plasma and intraperitoneal pharmacokinetics of ceftazidime\/avibactam in peritoneal dialysis patients","volume":"29","author":"al Jalali","year":"2023","journal-title":"Clin Microbiol Infect"},{"key":"2026052202033990400_dkag185-B16","doi-asserted-by":"publisher","first-page":"S96","DOI":"10.1177\/089686080802803s19","article-title":"Icodextrin and intraperitoneal inflammation","volume":"28","author":"Moriishi","year":"2008","journal-title":"Perit Dial Int"},{"key":"2026052202033990400_dkag185-B17","author":"Electronic medicines compendium"},{"key":"2026052202033990400_dkag185-B18","author":"European Committee on Antimicrobial Susceptibility Testing (EUCAST)"},{"key":"2026052202033990400_dkag185-B19","author":"The European Committee on Antimicrobial Susceptibility Testing"},{"key":"2026052202033990400_dkag185-B20","doi-asserted-by":"publisher","first-page":"2257","DOI":"10.1007\/s10096-015-2477-8","article-title":"The influence of different peritoneal dialysis fluids on the in vitro activity of ampicillin, daptomycin, and linezolid against Enterococcus faecalis","volume":"34","author":"Kussmann","year":"2015","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2026052202033990400_dkag185-B21","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1007\/s10096-011-1446-0","article-title":"Comparative in vitro antimicrobial activity of vancomycin, teicoplanin, daptomycin and ceftobiprole in four different peritoneal dialysis fluids","volume":"31","author":"Tobudic","year":"2012","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2026052202033990400_dkag185-B22","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/S1045-1870(99)80005-3","article-title":"New cephalosporins","volume":"10","author":"Singh","year":"1999","journal-title":"Semin Pediatr Infect Dis"},{"key":"2026052202033990400_dkag185-B23","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1093\/ckj\/sfac012","article-title":"Stability and compatibility of antibiotics in peritoneal dialysis solutions","volume":"15","author":"So","year":"2022","journal-title":"Clin Kidney J"},{"key":"2026052202033990400_dkag185-B24","doi-asserted-by":"publisher","first-page":"2446","DOI":"10.1016\/j.clinthera.2019.08.021","article-title":"High pyridine generation in ceftazidime-icodextrin admixtures used to treat peritoneal dialysis-associated peritonitis","volume":"41","author":"Kaur","year":"2019","journal-title":"Clin Ther"},{"key":"2026052202033990400_dkag185-B25","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1177\/0896860819887636","article-title":"Pyridine levels in ceftazidime \u2013 peritoneal dialysis admixtures stored at body temperature","volume":"40","author":"Nguyen","year":"2020","journal-title":"Perit Dial Int"},{"key":"2026052202033990400_dkag185-B26","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1159\/000186211","article-title":"Short dwell times reduce the local defence mechanism of chronic peritoneal dialysis patients","volume":"57","author":"Vlaanderen","year":"1991","journal-title":"Nephron"},{"key":"2026052202033990400_dkag185-B27","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1111\/1744-9987.12391","article-title":"Effects of icodextrin and glucose bicarbonate\/lactate-buffered peritoneal dialysis fluids on effluent cell population and biocompatibility markers IL-6 and CA125 in incident peritoneal dialysis patients","volume":"20","author":"Opatrn\u00e1","year":"2016","journal-title":"Ther Apher Dial"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/81\/6\/dkag185\/68365253\/dkag185.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/81\/6\/dkag185\/68365253\/dkag185.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T06:03:46Z","timestamp":1779429826000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/doi\/10.1093\/jac\/dkag185\/8690405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,5]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,5,5]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkag185","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,5,5]]},"article-number":"dkag185"}}