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首页> 外文期刊>Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery >Vancomycin administration in continuous ambulatory peritoneal dialysis: the risk of ototoxicity.
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Vancomycin administration in continuous ambulatory peritoneal dialysis: the risk of ototoxicity.

机译：持续非卧床腹膜透析中使用万古霉素：发生耳毒性的风险。

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摘要

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 trough level of 11.00 microg/ml on day 6 and mean serum levels of 33.8 and 38.6 microg/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.
机译：一项前瞻性研究在16名慢性肾脏衰竭患者中进行了持续的非卧床腹膜透析，其中22例腹膜炎由已知的耳毒性药物万古霉素治疗。 12例患者各发作一次，其中4例复发性腹膜炎。每个治疗过程均以每6天间隔两次在2 L腹膜透析液中输注万古霉素（30 mg / kg体重）。通过酶免疫测定法分析的血清万古霉素分别在第1天和第7天给药后第12天显示平均谷水平为11.00 microg / ml，平均血清水平分别为33.8和38.6 microg / ml。万古霉素对腹膜炎复发的反复发作遇到了相似的水平，完全在治疗范围内，这表明该药物的药代动力学特征没有变化。在每个疗程中进行的纯音测听，电眼描记术和临床评估均显示，即使在重复万古霉素治疗过程中也没有耳毒性的证据。结果表明，以适当浓度作为单一治疗剂给予万古霉素治疗既有效又安全。但是，我们认为，万古霉素与氨基糖苷类药物合用可能产生耳毒性作用，可能是由于协同作用而使耳毒性作用大大加重。

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