Vancomycin pharmacokinetics during continuous ambulatory peritoneal dialysis in patients with peritonitis. 2011

Belén Montañés Pauls, and Manuel Alós Almiñana, and Vicente G Casabó Alós
Pharmacy Service, El Pinar Nurse Home Hospital, Avd/Ferrandis Salvador No. 46, 12100 Castellón, Spain. montanyes_bel@gva.es

The aim of this study was to define a two-compartments pharmacokinetic model and to estimate the pharmacokinetic parameters of IP administered vancomycin in patients with continuous ambulatory peritoneal dialysis (CAPD) associated peritonitis. Ten patients with peritoneal dialysis treatment and peritonitis were prospectively enrolled in the study. The empiric treatment is: vancomycin 2 g every 5-7 days and ceftazidime 1500 mg per exchange, once daily. Pharmacokinetic modeling and parameter calculations were carried out using the nonlinear regression. The mean peritoneal concentration 10 min after the first peritoneal exchange of vancomycin free dialysis liquid was 9.5±7.3 μg/ml, showing that antibiotic quickly crosses from "systemic" to "peritoneal" compartment. Then, we can appreciate a progressive reduction in the mean peritoneal concentration till last sample time at 168 h. The mean plasma concentration 4 h after the first peritoneal exchange of vancomycin-free dialysis liquid was 39.6±7.6 μg/ml, inside classic interval therapeutic range for the peak concentration of vancomycin. Then, we can appreciate a progressive reduction in the mean plasma concentration till last sample time at 168 h. Simultaneous joint analysis of the experimental plasma and peritoneal data of vancomycin in patients under CAPD with peritonitis, using the two-compartments model, sets up a physiologic model that adapts suitably to the intraperitoneal pharmacotherapy.

UI MeSH Term Description Entries
D007274 Injections, Intraperitoneal Forceful administration into the peritoneal cavity of liquid medication, nutrient, or other fluid through a hollow needle piercing the abdominal wall. Intraperitoneal Injections,Injection, Intraperitoneal,Intraperitoneal Injection
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010531 Peritoneal Dialysis, Continuous Ambulatory Portable peritoneal dialysis using the continuous (24 hours a day, 7 days a week) presence of peritoneal dialysis solution in the peritoneal cavity except for periods of drainage and instillation of fresh solution. CAPD,Continuous Ambulatory Peritoneal Dialysis
D010538 Peritonitis INFLAMMATION of the PERITONEUM lining the ABDOMINAL CAVITY as the result of infectious, autoimmune, or chemical processes. Primary peritonitis is due to infection of the PERITONEAL CAVITY via hematogenous or lymphatic spread and without intra-abdominal source. Secondary peritonitis arises from the ABDOMINAL CAVITY itself through RUPTURE or ABSCESS of intra-abdominal organs. Primary Peritonitis,Secondary Peritonitis,Peritonitis, Primary,Peritonitis, Secondary
D002442 Ceftazidime Semisynthetic, broad-spectrum antibacterial derived from CEPHALORIDINE and used especially for Pseudomonas and other gram-negative infections in debilitated patients. Ceftazidime Anhydrous,Ceftazidime Pentahydrate,Fortaz,Fortum,GR-20263,LY-139381,Pyridinium, 1-((7-(((2-amino-4-thiazolyl)((1-carboxy-1-methylethoxy)imino)acetyl)amino)-2-carboxy-8-oxo-5-thia-1-azabicyclo(4.2.0)oct-2-en-3-yl)methyl)-, inner salt, pentahydrate, (6R-(6alpha,7beta(Z)))-,Tazidime,GR 20263,GR20263,LY 139381,LY139381
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial

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