Vancomycin in peritoneal dialysis: Clinical pharmacology considerations in therapy. Issue 4 (July 2020)

• Record Type: Journal Article
• Authors: Lam, Edwin; Lien, Yi Ting (Kayla); Kraft, Water K; Piraino, Beth; Vozmediano, Valvanera; Schmidt, Stephan; Zhang, Jingjing
• Is Part Of: Peritoneal dialysis international. Volume 40:Issue 4(2020)
• Page Start: 384
• Page End: 393
• Publication Date: 2020-07
• Subjects: Anuria -- automated peritoneal dialysis -- continuous ambulatory peritoneal dialysis -- peritonitis -- pharmacodynamics -- pharmacokinetics -- residual kidney function; Peritoneal dialysis -- Periodicals; Continuous ambulatory peritoneal dialysis -- Periodicals; 617.461059
• DOI: 10.1177/0896860819889774
• Languages: English
• ISSNs: 0896-8608

Abstract

Intraperitoneal vancomycin is the first-line therapy in the management of peritoneal dialysis (PD)-related peritonitis. However, due to the paucity of data, vancomycin dosing for peritonitis in patients on automated peritoneal dialysis (APD) is empiric and based on clinical experience rather than evidence. Studies in continuous ambulatory peritoneal dialysis (CAPD) patients have been used to provide guidelines for dosing and are often extrapolated for APD use, but it is unclear whether this is appropriate. This review summarizes the available pharmacokinetic data used to inform optimal dosing in patients on CAPD or APD. The determinants of vancomycin disposition and pharmacodynamic effects are critically summarized, knowledge gaps explored, and a vancomycin dosing algorithm in PD patients is proposed.