Intraperitoneal V Ancoled Does Not Cause Chemical Peritonitis

Abstract

We prospectively examined the peritoneal effects of i.p. Vancoled given to 5 patients with catheter-associated exit-site infections. All patients were free of peritonitis before receiving the drug. A standard dose of 30 mg/kg total body weight was given i.p. to each patient. Informed consent was obtained. Pre-drug dialysate cultures and cell counts were performed. The drug was added to fresh dialysate (dose range 1900 to 2800 mg) and instilled in the usual manner. Two hours later, an aliquot of dialysate was withdrawn from the peritoneal cavity. At 4 h, the entire dialysis exchange was drained. Dialysate samples obtained at 2 and 4 h were cultured and cell counts were performed. Baseline pre-drug dialysate fluid contained less than 9 WBCs/ μL in all patients. Two and 4 h samples contained less than 4 and 11 WBCs/μL, respectively. All fluid samples were sterile. WBC differential counts were unremarkable, and no adverse events were observed. The mean serum vancomycin concentration 4 h after the dose was instilled was 26.5 μg/mL (range 19.9-35.2 μg/mL). Intraperitoneal Vancoled did not cause chemical peritonitis, and was well-tolerated by patients with exit-site infections.