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Chemical peritonitis secondary to intraperitoneal vancomycin.
1Department of Medicine, Brooke Army Medical Center, San Antonio, TX 78234-6200.
Summary
Chemical peritonitis from intraperitoneal vancomycin in peritoneal dialysis patients can occur. Differences in vancomycin preparation impurities may explain these sterile peritonitis episodes.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Sterile peritonitis associated with intraperitoneal vancomycin in peritoneal dialysis (PD) patients is controversial.
- Previous reports suggested brand-specific vancomycin preparations might be implicated.
Observation:
- Four episodes of sterile peritonitis were observed in three PD patients receiving intraperitoneal vancomycin.
- These episodes occurred after switching from Vancocin to a generic vancomycin preparation.
Findings:
- High-performance liquid chromatography (HPLC) revealed Vancocin had fewer impurities than the generic preparation.
- Impurities in non-Vancocin vancomycin preparations may contribute to chemical peritonitis.
Implications:
- This study supports the occurrence of chemical peritonitis due to intraperitoneal vancomycin.
- Increased clinical awareness is needed to identify and manage these adverse events in PD patients.