Vancomycin kinetics during continuous ambulatory peritoneal dialysis

Clin Pharmacol Ther. 1983 Nov;34(5):631-7. doi: 10.1038/clpt.1983.225.


To establish therapeutic guidelines for vancomycin usage in patients receiving continuous ambulatory peritoneal dialysis (CAPD), we studied single-dose kinetics of vancomycin in CAPD patients. Vancomycin was studied after a 10-mg/kg dose was given intravenously (VAN-IV) or intraperitoneally (VAN-IP). VAN-IV provided a plasma concentration above 10 mg/l at 12 hr, with a t 1/2 of 81 hr. When VAN-IP was given, 65% was absorbed; peak plasma concentrations were only 6.3 mg/l, and t 1/2 was 66 hr. CAPD accounted for only 15% to 17% of total body clearance in both groups. The kinetic principle of superposition was used to predict plasma concentrations after repeated VAN-IP doses. A model with once-a-day dosing predicted that a loading dose of 30 mg/kg followed by 7 mg/kg would achieve steady-state plasma concentrations of 11 to 14.8 mg/l. Another model with vancomycin in each exchange predicted that a loading dose of 30 mg/kg followed by 1.5 mg/kg would provide plasma concentrations in excess of 10 mg/l at 180 hr. These data should be useful in vancomycin treatment of CAPD patients who have nonperitoneal gram-positive bacterial infections, as well as those who have peritonitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Humans
  • Injections, Intraperitoneal
  • Injections, Intravenous
  • Kinetics
  • Middle Aged
  • Peritoneal Dialysis / adverse effects*
  • Peritoneal Dialysis, Continuous Ambulatory / adverse effects*
  • Peritonitis / drug therapy
  • Peritonitis / etiology
  • Vancomycin / metabolism*
  • Vancomycin / therapeutic use


  • Vancomycin