Ayus J C, Eneas J F, Tong T G, Benowitz N L, Schoenfeld P Y, Hadley K L, Becker C E, Humphreys M H
Clin Nephrol. 1979 Mar;11(3):129-32.
Vancomycin is a useful antimicrobial agent in patients undergoing chronic hemodialysis treatment; its efficacy in chronic peritoneal dialysis (CPD) has not been established. Serum (VS) and peritoneal fluid (VPF) vancomycin concentrations were measured in two CPD patients with staphylococcal peritonitis. Half-life of VS agreed with the half-life of VPF in each patient, and the VS/VPF ratio was 1.27 in both patients. Distribution volumes were 37.2 and 58.7 l, values approximating total body water in these patients. VS and VPF persisted in the therapeutic range (greater than 5 microgram/ml) for more than 16 days. In one patient, mean peritoneal clearacne was 9.8 ml/min, and overall drug clearance averaged 2.3 ml/min; in the other patient, overall clearance was 2.1 ml/min. These results indicate that therapeutic vancomycin levels can be maintained for more than 16 days with a single 1 g intravenous dose in patients receiving intermittent CPD, as is the case for hemodialysis patients. Because of this, parenteral vancomycin is useful in the treatment of staphylococcal peritonitis in CPD patients.
万古霉素对于接受慢性血液透析治疗的患者是一种有效的抗菌药物；但其在慢性腹膜透析（CPD）中的疗效尚未得到证实。对两名患有葡萄球菌性腹膜炎的CPD患者测定了血清（VS）和腹膜液（VPF）中的万古霉素浓度。每名患者的VS半衰期与VPF半衰期一致，且两名患者的VS/VPF比值均为1.27。分布容积分别为37.2升和58.7升，这些数值接近这些患者的总体液量。VS和VPF在治疗范围内（大于5微克/毫升）持续超过16天。在一名患者中，平均腹膜清除率为9.8毫升/分钟，总体药物清除率平均为2.3毫升/分钟；在另一名患者中，总体清除率为2.1毫升/分钟。这些结果表明，对于接受间歇性CPD的患者，单次静脉注射1克万古霉素可使治疗性万古霉素水平维持超过16天，血液透析患者也是如此。因此，胃肠外给予万古霉素对于治疗CPD患者的葡萄球菌性腹膜炎是有用的。
