Therapeutic Drug Monitoring in Peritoneal Dialysis: A Case of Klebsiella pneumoniae Peritonitis Treated with Gentamicin.
DOI:
https://doi.org/10.70672/gt5tjz74Keywords:
Continuous ambulatory peritoneal dialysis, gentamicin, peritonitis, therapeutic drug monitoring,Abstract
Peritonitis is a common complication of peritoneal dialysis. Prompt initiation of antibiotic therapy is consistently associated with improved outcomes. Antibiotics for peritonitis may be delivered via the intraperitoneal or systemic route. The pharmacokinetics of gentamicin in patients on continuous ambulatory peritoneal dialysis (CAPD) are highly variable, complicating dosing decisions to balance between efficacy and avoid toxicity. The implementation of therapeutic drug monitoring is important in adjusting gentamicin serum concentrations in patients receiving CAPD.
References
[1]. Ranganathan D, Varghese JM, Fassett RG, et al. Optimising intraperitoneal gentamicin dosing in peritoneal dialysis patients with peritonitis (GIPD) study. BMC Nephrol. 2009;10:42. doi:10.1186/1471-2369-10-42.
[2]. Li PK, Chow KM, Cho Y, et al. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Perit Dial Int. 2022;42(2):110-153. doi: 10.1177/08968608221080586.
[3]. Farkas A, Oikonomou K, Ghanbar M, Villasurda P, Varghese J, Lipman J, et al. Population pharmacokinetics of intraperitoneal gentamicin and the impact of varying dwell times on pharmacodynamic target attainment in patients with acute peritonitis undergoing peritoneal dialysis. Antimicrob Agents Chemother. 2022;66(2):e01679-21. doi:10.1128/AAC.01679-21.
[4]. Tang W, Cho Y, Hawley CM, Badve SV, Johnson DW. The role of monitoring gentamicin levels in patients with gram-negative peritoneal dialysis-associated peritonitis. Perit Dial Int. 2014;34(2):219-226. doi:10.3747/pdi.2012.00318.
[5]. Khan SF. Updates on infectious and other complications in peritoneal dialysis: core curriculum 2023. Am J Kidney Dis. 2023;82(4):481-490. doi: 10.1053/j.ajkd.2023.03.011.
[6]. Van der Hulst RJ, Boeschoten EW, Nielsen FW, et al. Ototoxicity monitoring with ultra-high frequency audiometry in peritoneal dialysis patients treated with vancomycin or gentamicin. ORL J Otorhinolaryngol Relat Spec. 1991;53(1):19-22. doi: 10.1159/000276178.
[7]. Johnson DW. Do antibiotic levels need to be followed in treating peritoneal dialysis-associated peritonitis? Semin Dial. 2011;24(4):445-446. doi: 10.1111/j.1525-139X.2011.00883.x
[8]. Varghese JM, Roberts JA, Wallis SC, Boots RJ, Healy H, Fassett RG, et al. Pharmacokinetics of intraperitoneal gentamicin in peritoneal dialysis patients with peritonitis (GIPD Study). Clin J Am Soc Nephrol. 2012;7(8):1249-1256. doi:10.2215/CJN.12211211.
[9]. Florczykowski B, Storer A. Gentamicin dosing and monitoring challenges in end-stage renal disease. Adv Pharmacoepidemiol Drug Saf. 2013;2:135. doi:10.4172/2167-1052.1000135.
[10]. Veinstein A, Venisse N, Badin J, Pinsard M, Robert R, Dupuis A. Gentamicin in hemodialyzed critical care patients: early dialysis after administration of a high dose should be considered. Antimicrob Agents Chemother. 2013;57(2):977-982. doi:10.1128/AAC.01762-12.
[11]. Halouzková BA, Hartinger JM, Krátký J, Tesař V, Slanař O. Dosing of aminoglycosides in chronic kidney disease and end-stage renal disease patients treated with intermittent hemodialysis. Kidney Blood Press Res. 2022;47(7):448-458. doi:10.1159/000523892.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Asian Journal of Medicine & Health Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Journal of Engineering Technology (JET) is an open-access journal that follows the Creative Commons Attribution-Non-commercial 4.0 International License (CC BY-NC 4.0)
