title: Treatment of enterococcal peritonitis with intraperitoneal daptomycin in a vancomycin-allergic patient and a review of the literature.
abstract: BACKGROUND
  Intraperitoneal (IP) administration of antibiotics is a mainstay of therapy in the treatment of peritoneal dialysis-related peritonitis. The therapeutic options against gram-positive organisms in patients intolerant to vancomycin are limited.
  
  
  METHODS
  This case report and review of the literature used a search of PubMed with the terms "daptomycin," "intraperitoneal," and "peritoneal" for 2004 through 7 February 2013 to find relevant publications.
  
  
  RESULTS
  In addition to our patient, we identified 6 case reports of IP daptomycin for the treatment of peritonitis. Our patient was treated with a 14-day course of IP daptomycin, with resolution of signs and symptoms of peritonitis. She presented again 7 weeks later with signs and symptoms of peritonitis and was treated with a repeat course of IP daptomycin. Among the 6 patients reported in the literature, 4 received loading doses of daptomycin. Daptomycin 20 mg per liter of dialysate was administered in 4 patients, and the other 2 patients received higher doses based on body weight (milligrams per kilogram). Treatment duration averaged 10 or 14 days. In all 6 cases, clinical cure was reported.
  
  
  CONCLUSIONS
  Although limited to case reports, the available literature suggests that IP daptomycin is a viable alternative for peritoneal dialysis-related peritonitis. However, routine use of this agent must be cautioned, because further prospective studies are required.
authors.affiliation: Department of Pharmacy Services, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Gilmore
authors.forename: Miae
authors.initials: M
authors.lastname: Kim
authors.forename: Mary T
authors.initials: MT
authors.lastname: LaSalvia
authors.forename: Monica V Golik
authors.initials: MV
authors.lastname: Mahoney
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017576:Daptomycin / Q000008:administration & dosage*; D015314:Dialysis Solutions / Q000737:chemistry*; D004342:Drug Hypersensitivity; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D014640:Vancomycin / Q000276:immunology
chemical_list: D000900:Anti-Bacterial Agents; D015314:Dialysis Solutions; D014640:Vancomycin; D017576:Daptomycin
keywords: Daptomycin; intraperitoneal; peritonitis