Evaluation of intraperitoneal vancomycin in peritoneal dialysis-associated peritonitis
Background: Intraperitoneal (IP) vancomycin is recommended as one of the treatment options for gram-positive coverage in the management of peritoneal dialysis (PD)-associated peritonitis. There is a lack of literature supporting the optimal dose and approach to vancomycin therapeutic drug-level moni...
Gespeichert in:
| Veröffentlicht in: | Peritoneal dialysis international 2022-03, Vol.42 (2), p.171-176 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 176 |
|---|---|
| container_issue | 2 |
| container_start_page | 171 |
| container_title | Peritoneal dialysis international |
| container_volume | 42 |
| creator | Chang, Wui Ming Cheng, Elaine Shalansky, Karen Singh, Suneet R |
| description | Background:
Intraperitoneal (IP) vancomycin is recommended as one of the treatment options for gram-positive coverage in the management of peritoneal dialysis (PD)-associated peritonitis. There is a lack of literature supporting the optimal dose and approach to vancomycin therapeutic drug-level monitoring.
Methods:
A retrospective chart review was conducted using the BC Renal Agency PROMIS Database and our hospital records from 1 June 2011 to 1 July 2019. Adult patients with PD-associated peritonitis who received IP vancomycin and had at least one serum vancomycin level drawn were included. All patients received a loading dose of 30 mg/kg, which was repeated every 3–5 days depending on PD modality. Serum vancomycin levels were drawn prior to the second vancomycin dose, then at the discretion of the prescriber. The primary end point was the rate of therapeutic serum vancomycin levels ≥15 mg/L.
Results:
Twenty-three episodes of PD-associated peritonitis in 20 patients met the eligibility criteria. Only 15/23 serum vancomycin levels were drawn appropriately after the first dose. Sixty per cent of these levels were subtherapeutic at |
| doi_str_mv | 10.1177/08968608211051579 |
| format | Article |
| fullrecord | <record><control><sourceid>sage_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1177_08968608211051579</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_08968608211051579</sage_id><sourcerecordid>10.1177_08968608211051579</sourcerecordid><originalsourceid>FETCH-LOGICAL-c340t-b198a38decc4215e6a0bdc4b48605a80a01a03d0c5f3d5c3510f48a3e3d95e963</originalsourceid><addsrcrecordid>eNp9kE1Lw0AQhhdRbKn9AV4kfyB1pvuZo5RqhYIX9RomuxtZSZOymxb6702pFUHwNIfnfYaZl7FbhBmi1vdgCmUUmDkiSJS6uGBj1GhywUFcsvGR58fAiE1TChUIUSghtLlmIy6UFlKrMXtf7qnZUR-6NuvqLLR9pK2Poe9aT022p9Z2m4MN7YCyX8AFag4ppJxS6myg3rszDn1IN-yqpib56fecsLfH5etila9fnp4XD-vccgF9XmFhiBvnrRVzlF4RVM6KSgx3SzJAgATcgZU1d9JyiVCLwfDcFdIXik8Ynvba2KUUfV1uY9hQPJQI5bGm8k9Ng3N3cra7auPdj3EuZQjMToFEH7787HaxHX74Z-MXQs5x0w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Evaluation of intraperitoneal vancomycin in peritoneal dialysis-associated peritonitis</title><source>Access via SAGE</source><source>MEDLINE</source><creator>Chang, Wui Ming ; Cheng, Elaine ; Shalansky, Karen ; Singh, Suneet R</creator><creatorcontrib>Chang, Wui Ming ; Cheng, Elaine ; Shalansky, Karen ; Singh, Suneet R</creatorcontrib><description>Background:
Intraperitoneal (IP) vancomycin is recommended as one of the treatment options for gram-positive coverage in the management of peritoneal dialysis (PD)-associated peritonitis. There is a lack of literature supporting the optimal dose and approach to vancomycin therapeutic drug-level monitoring.
Methods:
A retrospective chart review was conducted using the BC Renal Agency PROMIS Database and our hospital records from 1 June 2011 to 1 July 2019. Adult patients with PD-associated peritonitis who received IP vancomycin and had at least one serum vancomycin level drawn were included. All patients received a loading dose of 30 mg/kg, which was repeated every 3–5 days depending on PD modality. Serum vancomycin levels were drawn prior to the second vancomycin dose, then at the discretion of the prescriber. The primary end point was the rate of therapeutic serum vancomycin levels ≥15 mg/L.
Results:
Twenty-three episodes of PD-associated peritonitis in 20 patients met the eligibility criteria. Only 15/23 serum vancomycin levels were drawn appropriately after the first dose. Sixty per cent of these levels were subtherapeutic at <15 mg/L. All subsequent serum vancomycin levels were above the therapeutic target. Most peritonitis episodes (78%) achieved resolution of infection. Residual kidney function was not significantly correlated with serum vancomycin levels (p = 0.19).
Conclusions:
An IP vancomycin regimen of 30 mg/kg every 3–5 days resulted in subtherapeutic serum vancomycin levels in most patients following the loading dose but therapeutic levels thereafter. A large percentage of vancomycin levels were drawn inappropriately due to misalignment of outpatient follow-up visits and timing of blood work.</description><identifier>ISSN: 0896-8608</identifier><identifier>EISSN: 1718-4304</identifier><identifier>DOI: 10.1177/08968608211051579</identifier><identifier>PMID: 34674576</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Anti-Bacterial Agents - therapeutic use ; Drug Monitoring ; Humans ; Peritoneal Dialysis - adverse effects ; Peritonitis - drug therapy ; Peritonitis - etiology ; Retrospective Studies ; Vancomycin - therapeutic use</subject><ispartof>Peritoneal dialysis international, 2022-03, Vol.42 (2), p.171-176</ispartof><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c340t-b198a38decc4215e6a0bdc4b48605a80a01a03d0c5f3d5c3510f48a3e3d95e963</citedby><cites>FETCH-LOGICAL-c340t-b198a38decc4215e6a0bdc4b48605a80a01a03d0c5f3d5c3510f48a3e3d95e963</cites><orcidid>0000-0002-1403-3730</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/08968608211051579$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/08968608211051579$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34674576$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, Wui Ming</creatorcontrib><creatorcontrib>Cheng, Elaine</creatorcontrib><creatorcontrib>Shalansky, Karen</creatorcontrib><creatorcontrib>Singh, Suneet R</creatorcontrib><title>Evaluation of intraperitoneal vancomycin in peritoneal dialysis-associated peritonitis</title><title>Peritoneal dialysis international</title><addtitle>Perit Dial Int</addtitle><description>Background:
Intraperitoneal (IP) vancomycin is recommended as one of the treatment options for gram-positive coverage in the management of peritoneal dialysis (PD)-associated peritonitis. There is a lack of literature supporting the optimal dose and approach to vancomycin therapeutic drug-level monitoring.
Methods:
A retrospective chart review was conducted using the BC Renal Agency PROMIS Database and our hospital records from 1 June 2011 to 1 July 2019. Adult patients with PD-associated peritonitis who received IP vancomycin and had at least one serum vancomycin level drawn were included. All patients received a loading dose of 30 mg/kg, which was repeated every 3–5 days depending on PD modality. Serum vancomycin levels were drawn prior to the second vancomycin dose, then at the discretion of the prescriber. The primary end point was the rate of therapeutic serum vancomycin levels ≥15 mg/L.
Results:
Twenty-three episodes of PD-associated peritonitis in 20 patients met the eligibility criteria. Only 15/23 serum vancomycin levels were drawn appropriately after the first dose. Sixty per cent of these levels were subtherapeutic at <15 mg/L. All subsequent serum vancomycin levels were above the therapeutic target. Most peritonitis episodes (78%) achieved resolution of infection. Residual kidney function was not significantly correlated with serum vancomycin levels (p = 0.19).
Conclusions:
An IP vancomycin regimen of 30 mg/kg every 3–5 days resulted in subtherapeutic serum vancomycin levels in most patients following the loading dose but therapeutic levels thereafter. A large percentage of vancomycin levels were drawn inappropriately due to misalignment of outpatient follow-up visits and timing of blood work.</description><subject>Adult</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Drug Monitoring</subject><subject>Humans</subject><subject>Peritoneal Dialysis - adverse effects</subject><subject>Peritonitis - drug therapy</subject><subject>Peritonitis - etiology</subject><subject>Retrospective Studies</subject><subject>Vancomycin - therapeutic use</subject><issn>0896-8608</issn><issn>1718-4304</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1Lw0AQhhdRbKn9AV4kfyB1pvuZo5RqhYIX9RomuxtZSZOymxb6702pFUHwNIfnfYaZl7FbhBmi1vdgCmUUmDkiSJS6uGBj1GhywUFcsvGR58fAiE1TChUIUSghtLlmIy6UFlKrMXtf7qnZUR-6NuvqLLR9pK2Poe9aT022p9Z2m4MN7YCyX8AFag4ppJxS6myg3rszDn1IN-yqpib56fecsLfH5etila9fnp4XD-vccgF9XmFhiBvnrRVzlF4RVM6KSgx3SzJAgATcgZU1d9JyiVCLwfDcFdIXik8Ynvba2KUUfV1uY9hQPJQI5bGm8k9Ng3N3cra7auPdj3EuZQjMToFEH7787HaxHX74Z-MXQs5x0w</recordid><startdate>202203</startdate><enddate>202203</enddate><creator>Chang, Wui Ming</creator><creator>Cheng, Elaine</creator><creator>Shalansky, Karen</creator><creator>Singh, Suneet R</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0002-1403-3730</orcidid></search><sort><creationdate>202203</creationdate><title>Evaluation of intraperitoneal vancomycin in peritoneal dialysis-associated peritonitis</title><author>Chang, Wui Ming ; Cheng, Elaine ; Shalansky, Karen ; Singh, Suneet R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c340t-b198a38decc4215e6a0bdc4b48605a80a01a03d0c5f3d5c3510f48a3e3d95e963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Drug Monitoring</topic><topic>Humans</topic><topic>Peritoneal Dialysis - adverse effects</topic><topic>Peritonitis - drug therapy</topic><topic>Peritonitis - etiology</topic><topic>Retrospective Studies</topic><topic>Vancomycin - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, Wui Ming</creatorcontrib><creatorcontrib>Cheng, Elaine</creatorcontrib><creatorcontrib>Shalansky, Karen</creatorcontrib><creatorcontrib>Singh, Suneet R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Peritoneal dialysis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, Wui Ming</au><au>Cheng, Elaine</au><au>Shalansky, Karen</au><au>Singh, Suneet R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of intraperitoneal vancomycin in peritoneal dialysis-associated peritonitis</atitle><jtitle>Peritoneal dialysis international</jtitle><addtitle>Perit Dial Int</addtitle><date>2022-03</date><risdate>2022</risdate><volume>42</volume><issue>2</issue><spage>171</spage><epage>176</epage><pages>171-176</pages><issn>0896-8608</issn><eissn>1718-4304</eissn><abstract>Background:
Intraperitoneal (IP) vancomycin is recommended as one of the treatment options for gram-positive coverage in the management of peritoneal dialysis (PD)-associated peritonitis. There is a lack of literature supporting the optimal dose and approach to vancomycin therapeutic drug-level monitoring.
Methods:
A retrospective chart review was conducted using the BC Renal Agency PROMIS Database and our hospital records from 1 June 2011 to 1 July 2019. Adult patients with PD-associated peritonitis who received IP vancomycin and had at least one serum vancomycin level drawn were included. All patients received a loading dose of 30 mg/kg, which was repeated every 3–5 days depending on PD modality. Serum vancomycin levels were drawn prior to the second vancomycin dose, then at the discretion of the prescriber. The primary end point was the rate of therapeutic serum vancomycin levels ≥15 mg/L.
Results:
Twenty-three episodes of PD-associated peritonitis in 20 patients met the eligibility criteria. Only 15/23 serum vancomycin levels were drawn appropriately after the first dose. Sixty per cent of these levels were subtherapeutic at <15 mg/L. All subsequent serum vancomycin levels were above the therapeutic target. Most peritonitis episodes (78%) achieved resolution of infection. Residual kidney function was not significantly correlated with serum vancomycin levels (p = 0.19).
Conclusions:
An IP vancomycin regimen of 30 mg/kg every 3–5 days resulted in subtherapeutic serum vancomycin levels in most patients following the loading dose but therapeutic levels thereafter. A large percentage of vancomycin levels were drawn inappropriately due to misalignment of outpatient follow-up visits and timing of blood work.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>34674576</pmid><doi>10.1177/08968608211051579</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-1403-3730</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0896-8608 |
| ispartof | Peritoneal dialysis international, 2022-03, Vol.42 (2), p.171-176 |
| issn | 0896-8608 1718-4304 |
| language | eng |
| recordid | cdi_crossref_primary_10_1177_08968608211051579 |
| source | Access via SAGE; MEDLINE |
| subjects | Adult Anti-Bacterial Agents - therapeutic use Drug Monitoring Humans Peritoneal Dialysis - adverse effects Peritonitis - drug therapy Peritonitis - etiology Retrospective Studies Vancomycin - therapeutic use |
| title | Evaluation of intraperitoneal vancomycin in peritoneal dialysis-associated peritonitis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T01%3A09%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-sage_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Evaluation%20of%20intraperitoneal%20vancomycin%20in%20peritoneal%20dialysis-associated%20peritonitis&rft.jtitle=Peritoneal%20dialysis%20international&rft.au=Chang,%20Wui%20Ming&rft.date=2022-03&rft.volume=42&rft.issue=2&rft.spage=171&rft.epage=176&rft.pages=171-176&rft.issn=0896-8608&rft.eissn=1718-4304&rft_id=info:doi/10.1177/08968608211051579&rft_dat=%3Csage_cross%3E10.1177_08968608211051579%3C/sage_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/34674576&rft_sage_id=10.1177_08968608211051579&rfr_iscdi=true |