Bastani B, Freer K, Read D, Bailey S, Sherman R A, Davis M, Engels D, Westervelt F B
Nephron. 1987;45(4):283-5. doi: 10.1159/000184164.
Eight patients with end-stage renal failure on continuous ambulatory peritoneal dialysis (CAPD), who developed peritonitis, received an intraperitoneal dose of vancomycin (30 mg/kg body weight) with 6 h of peritoneal dwell and then resumed their routine CAPD schedule. Vancomycin concentration in serum, peritoneal dialysate (PD) from an overnight dwell and 1, 2 and 3 h after a new exchange was measured at 48 h (in 5 patients) and 7 days (in 6 patients). Except for an occasional 1-hour peritoneal fluid sample on the 7th day, all samples had satisfactory vancomycin levels. Five of the 8 patients who had gram-positive peritonitis and 1 with 'sterile' peritonitis received another similar intraperitoneal dose of vancomycin at the 7th day. All of these patients had good therapeutic response with a negative PD culture 3 weeks after the cessation of therapy and no relapse of infection in at least 1 month of follow-up. We conclude that 2 intraperitoneal doses of vancomycin (30 mg/kg body weight) given 1 week apart with 6 h of intraperitoneal dwell is an effective and adequate treatment for gram-positive and 'sterile' peritonitis in CAPD patients.
8例接受持续性非卧床腹膜透析（CAPD）的终末期肾衰竭患者发生了腹膜炎，他们接受了腹腔内注射万古霉素（30mg/kg体重），腹腔保留6小时，然后恢复常规CAPD方案。在48小时（5例患者）和7天（6例患者）时测量血清、过夜留存的腹膜透析液（PD）以及新换液后1、2和3小时的万古霉素浓度。除了第7天偶尔采集的1小时腹膜液样本外，所有样本的万古霉素水平都令人满意。8例革兰氏阳性腹膜炎患者中的5例和1例“无菌性”腹膜炎患者在第7天接受了另一剂类似的腹腔内万古霉素注射。所有这些患者治疗反应良好，治疗停止3周后腹膜透析液培养阴性，至少1个月的随访中无感染复发。我们得出结论，间隔1周给予2剂腹腔内万古霉素（30mg/kg体重），腹腔保留6小时，是治疗CAPD患者革兰氏阳性和“无菌性”腹膜炎的有效且充分的方法。
