Charney D I, Gouge S F
Department of Medicine, Brooke Army Medical Center, San Antonio, TX 78234-6200.
Am J Kidney Dis. 1991 Jan;17(1):76-9. doi: 10.1016/s0272-6386(12)80255-1.
Although previously reported in the literature, the existence of chemical peritonitis due to vancomycin in patients on peritoneal dialysis remains controversial. We report four similar episodes of sterile peritonitis in three patients receiving intraperitoneal (IP) vancomycin. The prior report implicated a change in the brand of vancomycin preparation, from Vancocin to Vancoled, as a contributing factor. We noted the occurrence of such episodes following a switch from Vancocin to a generic preparation from Abbott Laboratories. High-performance liquid chromatographic (HPLC) profiles of the three preparations show Vancocin to have a lower level of impurities than the other two; the presence of certain contaminants in the other brands may be contributing to the clinical difference observed. We conclude that chemical peritonitis due to IP vancomycin administration does occur, and that increased awareness of this entity could allow other cases to be identified.
尽管先前文献已有报道，但腹膜透析患者因万古霉素导致化学性腹膜炎的情况仍存在争议。我们报告了3例接受腹腔内（IP）注射万古霉素的患者出现的4起类似无菌性腹膜炎病例。先前的报告认为万古霉素制剂品牌从Vancocin更换为Vancoled是一个促成因素。我们注意到在从Vancocin更换为雅培实验室生产的仿制药制剂后出现了此类病例。这三种制剂的高效液相色谱（HPLC）图谱显示，Vancocin的杂质水平低于其他两种；其他品牌中某些污染物的存在可能导致了观察到的临床差异。我们得出结论，腹腔内注射万古霉素确实会导致化学性腹膜炎，提高对这一情况的认识有助于识别其他病例。
