Korean J Nephrol.
1999 Sep;18(5):741-746.
Intraperitoneal Vancomycin Induced Chemical Peritonitis in CAPD Patients
- Affiliations
-
- 1Department of Internal Medicine, College of Medicine, Yeungnam University, Taegu, Korea.
Abstract
-
BACKGROUND: Intraperitoneal(IP) vancomycin has been widely used for the treatment of
peritonitis or exit-site infection associated with continuous ambulatory peritoneal
dialysis(CAPD). However, some previous reports in the literature have suggested that IP
administration of certain vancomycin may be associated with chemical peritonitis in CAPD
patients.
METHODS
Between 1 February 1994 and 1 February 1997, 35 consecutive CAPD patients
requiring treatment with intraperitoneal vancomycin for either exit-site infection or
peritonitis in the Yeungnam University Hospital were recruited retrospectively into the study.
We compared retrospectively the incidence of chemical peritonitis after using two different
preparations of vancomycin from different pharmaceutical companies, namely vancocin CP(R) and
vancomycin(R).
RESULTS
Thirty-three cases(all 26 cases given vancocin CP(R) and 7 out of the 9 cases given
vancomycin(R)) showed improvement. None of them developed fever, abdominal pain or cloudy
dialysate. Out of the 9 cases given IP vancomycin(R), two who currently did not have abdominal
pain and cloudy dialysis effluent develolped these symptom and sign at 5 and 6 hours after
administration of IP vancomycin. The chemical peritonitis may be secondary to prolonged
contact of the peritoneal membrane with one or more of the impurities present in vancomycin
preparation.
CONCLUSION
In summary, it is necessary for the nephrologists to be aware of
the possible chemical peritonitis which can be caused by the impurities of certain brand
of vancomycin.