Management of candida peritonitis in a CAPD patient by flucytosine therapy: importance of drug level monitoring in body fluids
Giangrande, A.; Tortorano, A.M.; Limido, A.; Viviani, M.A.
Bollettino dell'Istituto Sieroterapico Milanese 62(5): 478-481
1983
ISSN/ISBN: 0021-2547 PMID: 6671030 Document Number: 214404
A 55-yr-old man on continuous ambulatory peritoneal dialysis developed C. albicans peritonitis. Therapy with amphotericin B was not tolerated and flucytosine (5-FC) [5-fluorocytosine] was given intraperitoneally (i.p.). Measurement of blood levels of 5-FC showed a good peritoneal absorption. Peak serum levels were achieved 8 h after the beginning of treatment, but the level was consistently lowered 12 h after the end of dialytic treatment. Blood levels were also measured after single test doses given by the oral and intravenous routes. Peritonitis signs cleared after therapy for 6 days. Data confirmed that 5-FC is absorbed satisfactorily after i.p. administration but in order to obtain effective blood levels in patients on dialysis, systemic 5-FC should also be given before and during the dialysis interval. The importance of monitoring serum levels of 5-FC in such patients is stressed.