Harford A M, Sica D A, Tartaglione T, Polk R E, Dalton H P, Poynor W
Nephron. 1986;43(3):217-22. doi: 10.1159/000183833.
Peritonitis has proven to be the major deterrent to the further growth of continuous ambulatory peritoneal dialysis (CAPD) as a treatment strategy for end-stage renal disease. The correct treatment of peritonitis remains unsettled as evidenced by the presence of advocates for oral, intravenous or intraperitoneal antibiotic administration. This study examines the pharmacokinetic parameters of intravenous vancomycin when employed in the therapy of peritonitis. One gram of intravenous vancomycin was administered during 7 episodes of peritonitis in 5 patients. Plasma and end-of-dwell dialysate levels were maintained above the minimum inhibitory concentration for Staphylococcus aureus and S. epidermidis for 7 days following this single dose of vancomycin. These data establish the existence of sustained intraperitoneal entry of intravenous vancomycin during peritonitis and raise for speculation its use as the sole therapy in most episodes of gram-positive peritonitis.
腹膜炎已被证明是持续非卧床腹膜透析（CAPD）作为终末期肾病治疗策略进一步发展的主要障碍。由于存在主张口服、静脉或腹腔内使用抗生素的人，腹膜炎的正确治疗方法仍未确定。本研究考察了静脉注射万古霉素用于腹膜炎治疗时的药代动力学参数。对5例患者的7次腹膜炎发作期间静脉注射了1克万古霉素。单次注射万古霉素后，血浆和透析结束时的透析液水平在7天内维持高于金黄色葡萄球菌和表皮葡萄球菌的最低抑菌浓度。这些数据证实了腹膜炎发作期间静脉注射万古霉素能持续进入腹腔，并引发了关于其在大多数革兰氏阳性腹膜炎发作中作为单一疗法使用的猜测。
