Vancomycin administration in continuous ambulatory peritoneal dialysis

The risk of ototoxicity

Balwant Singh Gendeh, A. G. Gibb, N. S. Aziz, N. Kong, Z. M. Zahir

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

A prospective study was undertaken in 16 patients with chronic renal failure on continuous ambulatory peritoneal dialysis, with 22 episodes of peritonitis treated with vancomycin, a known ototoxic agent. Twelve patients had one episode each, and four had recurrent peritonitis. Each treatment course consisted of two infusions of vancomycin (30 mg/kg body weight) in 2 L of peritoneal dialysate administered at 6-day intervals. Serum vancomycin analyzed by enzyme immunoassay showed a mean through level of 11.00 μg/ml on day 6 and mean serum levels of 33.8 and 38.6 μg/ml about 12 hours after administration on days 1 and 7, respectively. Similar levels, well within the therapeutic range, were encountered with repeated vancomycin therapy for recurrent episodes of peritonitis, suggesting that no changes occurred in the pharmacokinetic profile of the drug. Pure-tone audiometry, electronystagmography, and clinical assessment performed during each course of treatment showed no evidence of ototoxicity even on repeated courses of vancomycin therapy. The results suggest that vancomycin therapy when given in appropriate concentrations as a single therapeutic agent is both effective and safe. We believe, however, that vancomycin administered in combination with an aminoglycoside may produce ototoxic effects that may be greatly aggravated, possibly because of synergism.

Original languageEnglish
Pages (from-to)551-558
Number of pages8
JournalOtolaryngology - Head and Neck Surgery
Volume118
Issue number4
DOIs
Publication statusPublished - 1998

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Continuous Ambulatory Peritoneal Dialysis
Vancomycin
Peritonitis
Therapeutics
Electronystagmography
Pure-Tone Audiometry
Dialysis Solutions
Aminoglycosides
Serum
Immunoenzyme Techniques
Chronic Kidney Failure
Pharmacokinetics
Body Weight
Prospective Studies
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Vancomycin administration in continuous ambulatory peritoneal dialysis : The risk of ototoxicity. / Gendeh, Balwant Singh; Gibb, A. G.; Aziz, N. S.; Kong, N.; Zahir, Z. M.

In: Otolaryngology - Head and Neck Surgery, Vol. 118, No. 4, 1998, p. 551-558.

Research output: Contribution to journalArticle

Gendeh, Balwant Singh ; Gibb, A. G. ; Aziz, N. S. ; Kong, N. ; Zahir, Z. M. / Vancomycin administration in continuous ambulatory peritoneal dialysis : The risk of ototoxicity. In: Otolaryngology - Head and Neck Surgery. 1998 ; Vol. 118, No. 4. pp. 551-558.
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