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Toxicologic and pharmacokinetic evaluation of a case of vancomycin intoxication during continuous ambulatory peritoneal dialysis

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Abstract

The use of vancomycin is rapidly increasing due to the emergence of strains of staphylococci resistant to betalactam antibiotics. In this communication the pharmacokinetics of an overdose of vancomycin in a patient during continuous ambulatory peritoneal dialysis (CAPD) is reported. Brainstem auditory evoked potentials (BAEPs) are used to assess ototoxicity. It could be shown that by shortening the dwell time, the apparent CAPD flow was increased and the vancomycin clearance was also increased. This may explain in part the differences in the values of vancomycint 1/2 in this patient (21 h) as compared to other studies (60–120 h). The age of the patient (3.5 years) may also have influenced thet 1/2. Using brainstem auditory evoked potentials as a parameter to assess ototoxicity, it was shown that this patient suffered no damage from the overdose.

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Authors and Affiliations

  1. Department of Clinical Pharmacy, St. Radboud Hospital, Catholic University of Nijmegen, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    Y. A. Hekster & T. B. Vree

  2. Department of Paediatrics, St. Radboud Hospital, Catholic University of Nijmegen, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    C. M. R. Weemaes & J. J. Rotteveel

Authors
  1. Y. A. Hekster
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  2. T. B. Vree
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  3. C. M. R. Weemaes
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  4. J. J. Rotteveel
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Hekster, Y.A., Vree, T.B., Weemaes, C.M.R. et al. Toxicologic and pharmacokinetic evaluation of a case of vancomycin intoxication during continuous ambulatory peritoneal dialysis. Pharmaceutisch Weekblad Scientific Edition 8, 293–297 (1986). https://doi.org/10.1007/BF02280053

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  • DOI: https://doi.org/10.1007/BF02280053

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