[Pharmacokinetics of vancomycin in chronic renal failure patients in continuous ambulatory peritoneal dialysis (CAPD) after intra-abdominal administration]

Abstract

Peritonitis is one of the most serious complication concerning patients under continuous ambulatory peritoneal dialysis (CAPD). A Staphylococcus (aureus, epidermidis) is the causative pathogen in nearly 60% of cases. This prompted a study of vancomycin, a potent antistaphylococcal agent (MIC less than or equal to 3 micrograms/ml) in 13 patients with peritonitis. Vancomycin was used as single drug therapy. Kinetics were studied after a single injection of 1 g into the dialysate bag. Serum and peritoneal concentrations exceeding 3-4 micrograms/ml were found to persist for four days; half-life was 62.3 and 54.8 h in the dialysate and serum respectively. Peritoneum to serum diffusion varied widely across individuals. In 15% of patients, serum concentration exceeded the potentially ototoxic level (80 micrograms/ml) for a few hours.