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Characteristics of Vancomycin Blood Concentrations after Intraperitoneal Administration and Its Relationship with Efficacy in PDRP Patients with Peritoneal Dialysis-related Peritonitis
HANG Yong-fua, XU De-yub, XUE Linga, HU Kunb*, BIAN Yi-conga, SHEN Yan-pingb, HUANG Chen-ronga, YANG Jingb, LU Guo-yuanb, SHEN Leib, QIAO Qingb, SHA Wen-gangb, LI Mingb, ZHOU Lingb, MIAO Li-yana
a. Department of Pharmacy; b. Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
OBJECTIVE To evaluate the relationship between serum vancomycin level and efficacy in peritoneal dialysis-related peritonitis(PDRP) patients by analyzing our hospital′s data. METHODS Forty-six PDRP patients admitted in our hospital from August 2015 to April 2018 were collected, then divided into three groups by different regimens(1 g q3d, 1 g q4d, 1 g q5d), the probability of target attainment of the first trough concentration and those after several administrations, the characteristics of distribution of vancomycin serum level and the relation with efficacy were analyzed. RESULTS The first trough concentrations of 1 g q3d, 1 g q4d and 1 g q5d were (10.51±2.79), (6.78±1.58) and (6.68±1.68) mg·L-1 respectively, with statistical difference between 1 g q3d regimen and 1 g q4d, 1 g q5d (P��0.01). The trough concentration after the 3rd administration of 1 g q3d regimen was (16.15±4.79) mg·L-1, the trough concentration after the 2nd administration of 1 g q4d regimen was (10.20±2.0) mg·L-1, and the trough concentration after the 2nd administration of 1 g q5d regimen was (9.49±3.24) mg·L-1. The serum vancomycin level was increasing after repeated administration with obvious statistical difference among the three regimens(P��0.01). There was no significant difference in the efficacy between concentration��10 mg·L-1 and that ≥10 mg·L-1 or concentration <15 mg·L-1 and that ≥15 mg·L-1(P��0.05). CONCLUSION There is significant inter-individual differences of serum vancomycin level in PDRP patients after IP administration, and vancomycin is accumulated in body after repeated administration. It is suggested to monitor the serum vancomycin concentration and the trough concentration kept above 10 mg·L-1.
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