腹膜注射万古霉素导致pd相关性腹膜炎患者血清和腹膜流出液药物水平不理想。

IF 0.8 Q4 UROLOGY & NEPHROLOGY
Indian Journal of Nephrology Pub Date : 2025-07-01 Epub Date: 2024-09-19 DOI:10.25259/IJN_59_2024
Ezhilnilavan Sampath, Kapil Navin Sejpal, Apurba S Sastry, Sandhiya Selvarajan, P S Priyamvada, Sreejith Parameswaran
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引用次数: 0

摘要

背景:腹膜透析(PD)相关性腹膜炎常用万古霉素腹腔注射治疗。治疗药物水平监测有助于优化万古霉素在CKD患者中的应用。我们研究了终末期肾病患者使用万古霉素治疗pd相关性腹膜炎患者是否达到足够的血清水平。材料与方法:对连续19个月的pd相关性腹膜炎患者进行研究。患者接受万古霉素15 mg/kg Q96H和阿米卡星2 mg/kg的IP治疗,等待培养报告。在1、12、24和96小时,通过有效的液相色谱-串联质谱法测定血清和透析液中的万古霉素浓度。主要结果是血清和腹膜液中的药物水平,次要结果是腹膜炎治疗失败。结果:共治疗pd相关性腹膜炎45例,其中41例符合纳入标准,纳入PK分析。只有2例患者达到了推荐的血清万古霉素谷水平bb0 - 15mg /L。21次需要拔除导管。结论:在pd相关性腹膜炎患者中,间歇腹腔注射万古霉素15mg /kg / 96h不能达到推荐的万古霉素血清和透析液水平。迫切需要对PD人群中常用的IP抗生素进行药代动力学研究,以促进正确的剂量推荐。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Intraperitoneally Administered Vancomycin Results in Suboptimal Serum and Peritoneal Effluent Drug Levels in Patients with PD-related Peritonitis.

Intraperitoneally Administered Vancomycin Results in Suboptimal Serum and Peritoneal Effluent Drug Levels in Patients with PD-related Peritonitis.

Intraperitoneally Administered Vancomycin Results in Suboptimal Serum and Peritoneal Effluent Drug Levels in Patients with PD-related Peritonitis.

Background: Intraperitoneal vancomycin is commonly used to treat peritoneal dialysis (PD)-related peritonitis. Therapeutic drug level monitoring helps optimize the use of vancomycin in CKD patients. We studied whether sufficient serum levels were achieved in patients with PD-related peritonitis treated with the commonly used dose of vancomycin in patients with end stage renal disease.

Materials and methods: All consecutive patients with PD-related peritonitis during 19 months were studied. Patients received IP Vancomycin 15 mg/kg Q96H and amikacin 2 mg/kg while awaiting culture reports. Vancomycin concentration in serum and dialysate was determined by a validated liquid chromatography-tandem mass spectrometry assay at 1, 12, 24, and 96 h. The primary outcome was the drug levels in serum and peritoneal fluid, and the secondary outcome was peritonitis treatment failure.

Results: A total of 45 episodes of PD-related peritonitis were treated, of which 41 fulfilled the inclusion criteria and were included in the PK analysis. Recommended serum vancomycin trough level of >15 mg/L was achieved in only two cases. Twenty-one episodes required catheter removal.

Conclusion: In patients with PD-related peritonitis, intermittent intraperitoneal administration of 15 mg/kg of vancomycin every 96 h does not achieve the recommended serum and dialysate levels of vancomycin. There is an urgent need for pharmacokinetic studies on commonly used IP antibiotics in the PD population to facilitate correct dose recommendations.

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来源期刊
Indian Journal of Nephrology
Indian Journal of Nephrology UROLOGY & NEPHROLOGY-
CiteScore
1.40
自引率
0.00%
发文量
128
审稿时长
24 weeks
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