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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of chemical peritonitis associated with intraperitoneal vancomycin is reported. A 23-year-old woman presented with signs and symptoms consistent with a chronic ambulatory peritoneal dialysis catheter exit-site infection. Intraperitoneal vancomycin (Vancoled) 1 g was given, followed by 25 mg/L into each subsequent exchange. On day 4 the patient developed abdominal pain and cloudy dialysis effluent. The vancomycin was discontinued, and the dialysate cleared by day 8. Fluid cultures were negative, and Staphylococcus aureus was isolated from the exit site. Subsequent intravenous vancomycin, and smaller intraperitoneal doses, failed to repeat the event. Fluid and serum white blood cell count, serum immunoglobulins and complement, culture results, and the temporal relationship are strongly suggestive of a vancomycin-induced chemical peritonitis.
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PMID:Chemical peritonitis associated with intraperitoneal vancomycin. 187 69

Although previously reported in the literature, the existence of chemical peritonitis due to vancomycin in patients on peritoneal dialysis remains controversial. We report four similar episodes of sterile peritonitis in three patients receiving intraperitoneal (IP) vancomycin. The prior report implicated a change in the brand of vancomycin preparation, from Vancocin to Vancoled, as a contributing factor. We noted the occurrence of such episodes following a switch from Vancocin to a generic preparation from Abbott Laboratories. High-performance liquid chromatographic (HPLC) profiles of the three preparations show Vancocin to have a lower level of impurities than the other two; the presence of certain contaminants in the other brands may be contributing to the clinical difference observed. We conclude that chemical peritonitis due to IP vancomycin administration does occur, and that increased awareness of this entity could allow other cases to be identified.
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PMID:Chemical peritonitis secondary to intraperitoneal vancomycin. 198 71

A prior report has suggested that loading doses of intraperitoneal Vancoled (vancomycin, Lederle) cause chemical peritonitis in patients with catheter infections. The present open-label study was conducted to determine the effects of a 30 mg/kg intraperitoneal loading dose of Vancoled given to five patients with a culture-positive, erythematous, draining exit-site infection. Prior to dosing, all dialysate was drained and sent for baseline cell count and culture. The loading dose was added to the dialysate and infused in the usual fashion. A sample of dialysate was drained at two hours and sent for cell count and culture. The entire exchange was drained at four hours and also sent for cell count and culture. Serum vancomycin concentrations wer measured at four hours. Baseline dialysate contained less than 9 white blood cells per microliter in all patients. Two and four hour samples contained less than 4 and less than 11 white blood cells per microliter, respectively. All fluid was sterile. WB C differential counts were unremarkable. No adverse effects occurred. The mean serum vancomycin concentration was 26.5 micrograms/ml. Intraperitoneal Vancoled did not cause chemical peritonitis and was well-tolerated by patients with exit-site infections.
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PMID:Intraperitoneal Vancoled does not cause chemical peritonitis. 257 95