Questions About PD
Dear Dr. Kenda R,
Intraperitoneal vancomycin may be administered as 15 – 30 mg/kg body weight IP every 5-7 days for Intermittent use (per exchange, once daily). For continuous use (all exchanges) the recommendation is a loading dose of 1000mg/L plus a maintenance dose of 25mg/L (Perit Dial Int 2010 30: 393–423).
Since vancomycin absorption in the presence of peritonitis is closer to 90% no incremental dose is needed for sepsis. Generally, a dosing interval of 4 – 5 days will keep serum trough levels above 15 ug/mL but, in view of possible variability, it is best to obtain serum levels.
Systemic vancomycin administration might also be an option (Perit Dial Int 2004 24: 433–439).