Systemic Toxicity of Intraperitoneal Vancomycin

Kumar, T. Pavan; Teo, Iris; McCormick, Brendan

doi:10.1155/2016/3968690

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…In conclusion, IP vancomycin may be related to systemic adverse effects, 12 and DITP should be in the differential diagnosis when thrombocytopenia is observed in patients with peritonitis who are treated with vancomycin.…”

Section: Discussionmentioning

confidence: 94%

Intraperitoneal vancomycin‐induced immune thrombocytopenia

Murt

Tekin

Guzel

et al. 2021

Seminars in Dialysis

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Vancomycin is one of the drugs used in the peritonitis treatment regimen of peritoneal dialysis patients. Intraperitoneal route is generally preferred to provide rapid elimination of infective agents. Systemic toxicities of certain drugs after intraperitoneal administration are not very clear. The same also applies to vancomycin, although it has a considerable amount of systemic absorption after intraperitoneal administration. We herein report a case of severe thrombocytopenia, which was seen during the treatment of a peritonitis attack in a peritoneal dialysis patient. Culture studies revealed methicillin resistant staphylococci as the causative agent and the patient received intraperitoneal vancomycin per sensitivity analysis. Thrombocyte levels dropped abruptly to 3,900/μl after 10 days of vancomycin treatment. Clinical criteria pointed out to vancomycin‐related immune thrombocytopenia. Platelet levels did not recover with initial dexamethasone treatment and platelet transfusions. In the meantime, the clinical course was also complicated with intracranial bleeding. Intravenous immunoglobulin treatment was applied and dexamethasone was switched to high‐dose methylprednisolone. This latter treatment generated a response and platelet levels gradually increased to normal levels. The patient could be discharged without any sequelae. There have been two previous intraperitoneal vancomycin‐related immune thrombocytopenia cases in the literature. Previous cases were reviewed, and the present case was given in comparison with the previous cases.

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Section: Discussionmentioning

confidence: 94%

Intraperitoneal vancomycin‐induced immune thrombocytopenia

Murt

Tekin

Guzel

et al. 2021

Seminars in Dialysis

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“…Unfortunately, systemic delivery of broad-spectrum antibiotics is often associated with life-threatening negative side effects including vital organ damage such as nephrotoxicity and hepatotoxicity [ 13 , 14 , 15 , 16 , 17 ]. These negative side effects further complicate patient recovery and increase the morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Transdermal Delivery of High Molecular Weight Antibiotics to Deep Tissue Infections via Droplette Micromist Technology Device (DMTD)

et al. 2022

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Wound infection by multidrug-resistant (MDR) bacteria is a major disease burden. Systemic administration of broad-spectrum antibiotics colistin methanesulfonate (CMS) and vancomycin are the last lines of defense against deep wound infections by MDR bacteria. However, systemic administration of CMS and vancomycin are linked to life-threatening vital organ damage. Currently there are no effective topical application strategies to deliver these high molecular weight antibiotics across the stratum corneum. To overcome this difficulty, we tested if high molecular weight antibiotics delivered by Droplette micromist technology device (DMTD), a transdermal delivery device that generates a micromist capable of packaging large molecules, could attenuate deep skin tissue infections. Using green fluorescent protein-tagged E. coli and live tissue imaging, we show that (1) the extent of attenuation of deep-skin E. coli infection was similar when treated with topical DMTD- or systemic IP (intraperitoneal)-delivered CMS; (2) DMTD-delivered micromist did not spread the infection deeper; (3) topical DMTD delivery and IP delivery resulted in similar levels of vancomycin in the skin after a 2 h washout period; and (4) IP-delivered vancomycin was about 1000-fold higher in kidney and plasma than DMTD-delivered vancomycin indicating systemic toxicity. Thus, topical DMTD delivery of these antibiotics is a safe treatment for the difficult-to-treat deep skin tissue infections by MDR bacteria.

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“…Bacteria in biofilms are much more tolerant to antimicrobial agents and disinfectants [ 17 , 18 , 19 ], as well as host defense mechanisms [ 20 , 21 ]. Potent antibiotics or their combinations are usually used to treat complicated SSTIs caused by biofilm forming and multi-drug resistant bacteria, but their use may be associated with life-threatening toxicities such as nephrotoxicity and hepatotoxicity [ 22 , 23 , 24 ]. Thus there is a great unmet clinical need for novel anti-biofilm agents to treat infections associated with chronical wounds [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Preparation and Pharmacokinetic Characterization of an Anti-Virulence Compound Nanosuspensions

Wang

et al. 2021

Pharmaceutics

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Antibiotic resistance has become a worldwide public health threat due to the rapid evolution and spread of antibiotic-resistant bacteria. CCG-211790 is a novel anti-virulence compound that does not kill bacteria but could ameliorate human diseases by inhibiting expression of virulence factors, thereby applying less selection pressure for antibiotic resistance. However, its potential clinical use is restricted because of its poor aqueous solubility, resulting in formulation challenges. Nanosuspension technology is an effective way to circumvent this problem. Nanosuspensions of CCG-211790 with two different particle sizes, NanoA (315 ± 6 nm) and NanoB (915 ± 24 nm), were prepared using an antisolvent precipitation-ultrasonication method with Tween 80 as the stabilizer. Particle and pharmacokinetics (PK) of CCG-211790 nanosuspensions were characterized. Both NanoA and NanoB demonstrated remarkable increases in dissolution rate compared with the bulk compound. The PK parameters of NanoA were comparable to those of CCG-211790 solution formulation in intravenous or oral administration, suggesting that CCG-211790 nanosuspensions with smaller particle size improved oral bioavailability and drug exposure compared to traditional formulations of drug candidates.

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Systemic Toxicity of Intraperitoneal Vancomycin

Cited by 6 publications

References 16 publications

Intraperitoneal vancomycin‐induced immune thrombocytopenia

Intraperitoneal vancomycin‐induced immune thrombocytopenia

Transdermal Delivery of High Molecular Weight Antibiotics to Deep Tissue Infections via Droplette Micromist Technology Device (DMTD)

Preparation and Pharmacokinetic Characterization of an Anti-Virulence Compound Nanosuspensions

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