Adult Peritoneal Dialysis-Related Peritonitis Treatment Recommendations: 2000 Update

Keane, William F.; Bailie, George R.; Boeschoten, E. W.; Gokal, Ram; Golper, Thomas A.; Holmes, Clifford J.; Kawaguchi, Yoshindo; Piraino, Beth; Riella, Miguel C.; Vas, Stephen I.

doi:10.1177/089686080002000406

Cited by 371 publications

(415 citation statements)

References 42 publications

(10 reference statements)

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“…Episodes with peritoneal eosinophilia but with a negative bacterial culture were excluded. Bacterial culture of PDE was performed throughout the period in BacTAlert bottles (Organon Teknika, Durham, NC, USA), according to the recommendations of the International Society of Peritoneal Dialysis (ISPD) [7]. Isolation and identification of bacteria, as well as determination of antibiotic sensitivities, were performed according to the ISPD guidelines [7].…”

Section: Introductionmentioning

confidence: 99%

“…The average rate of response to antibiotic therapy was 60.1%, while 199 episodes (11.1%) required catheter removal. A combination of cefazolin and ceftazidime, the regimen recommended by the current guidelines of the ISPD [7], yielded a response rate of 66.9%. The rate of response to antibiotic therapy remained static during the 10-year period (details not shown); however, the percentage of cases that required an alteration in the antibiotic regimen rose from 13.6% in 1994 to 58.7% in 2003.…”

Section: Introductionmentioning

confidence: 99%

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Change in bacterial aetiology of peritoneal dialysis-related peritonitis over 10 years: experience from a centre in south-east Asia

Szeto

Leung

Chow

et al. 2005

Clinical Microbiology and Infection

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This study reviewed 1787 episodes of peritoneal dialysis (PD)-related peritonitis in 544 patients between 1994 and 2003. The overall rate of peritonitis was 0.68 episodes/year of PD, but decreased from 1.10 to 0.46 episodes/year between 1994 and 2003. The incidence of peritonitis caused by coagulase-negative staphylococci declined between 1994 and 1998 from 0.21 to 0.06 episodes/year of PD, coinciding with a reduction in the use of spike PD sets. There was a 60.1% response rate to antibiotics throughout the period, but the percentage of cases that required modification of the initial empirical antibiotic regimen rose from 13.6% to 58.7%, indicating that treatment should be individualised.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Change in bacterial aetiology of peritoneal dialysis-related peritonitis over 10 years: experience from a centre in south-east Asia

Szeto

Leung

Chow

et al. 2005

Clinical Microbiology and Infection

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“…In addition to these strategies, reports indicate methods to reduce the build-up of biofilm on catheters and treatment of nasal Staphylococcus aureus are considered current methods to prevent infection. 4 Exit-site care is reported to be integral to PD management, and one author has called for increased research activity in this field. 5 Luzar also suggested exit-site care has an impact on peritonitis rates, and that exit-site infections are as significant a complication of PD as peritonitis.…”

Section: Introductionmentioning

confidence: 99%

“…Typically, these involved the use of multifaceted interventions inclusive of cleaning with solutions such as potable tap water through to antibiotic or antiseptic solutions, the application or avoidance of covering dressings, and the use of antiseptic devices to assist in maintaining an infection free exit site. 2,4,5,[7][8][9][10][11][12] Current practice in each of these areas is variable and the optimal approach to exit-site care is not known. One survey of nurses and medical staff with 585/1800 respondents from across the USA found the most frequently performed aspects of exit-site care were daily hygiene, application of catheter stabilisation dressings, and use of cleansing agents.…”

Section: Introductionmentioning

confidence: 99%

Clinical effectiveness of different approaches to peritoneal dialysis catheter exit-site care

Lockwood

Hodgkinson

Page

2003

JBI Database of Systematic Reviews and Implementation Reports

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Executive summaryObjective The objective of this review was to appraise and synthesise the best available evidence on the clinical effectiveness of peritoneal dialysis catheter exit-site care. Inclusion criteriaThis review considered all randomised controlled trials that evaluated the effectiveness of peritoneal exit-site care. In the absence of randomised controlled trials, other controlled research designs such as non-randomised controlled trials were considered for inclusion in a narrative summary to enable the identification of current approaches and possible future strategies. Participants of interest were adults with chronic renal failure on maintenance peritoneal dialysis. Interventions of interest were those used to manage peritoneal catheter exit sites, and included types of dressings, frequency of dressings, types of skin care, and use of topical antiseptic or antimicrobial agents. Search strategyThe search sought to find both published and unpublished studies.An initial limited search of MEDLINE and CINAHL databases was undertaken to identify key words contained in the title or abstract, and index terms used to describe relevant articles. A second extensive search was undertaken using all identified key words and index terms. The third step was a search of the reference lists and bibliographies of all relevant articles.Methodological quality All identified studies that met the inclusion criteria were assessed for methodological validity by two reviewers prior to inclusion in the review. Critical appraisal of studies focused on identifying bias in selection, performance, attrition and detection. ResultsThis review found few studies of sufficient quality to meet the inclusion criteria.The included studies often utilised historical control groups, potentially confounding measurement of their outcomes. The outcome measures varied considerably, thus meta-analysis was not possible. ConclusionsThis review suggests topical mupirocin may reduce the risk of exit-site infection; however, the clinical effectiveness of any one antibiotic, antiseptic or dressing 168 C Lockwood et al.

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“…The most common microbial organisms associated with peritonitis are Gram-positive cocci, especially Staphylococcus, although Gram-negative bacterial and fungal infections occur at a lower frequency [7]. The guidelines for peritonitis issued by the International Society for Peritoneal Dialysis in 2000 suggest that first-generation cephalosporins in combination with ceftazidime should be used for both Gram-positive and Gram-negative organisms [8]. However, in cases of patients with a residual urine volume <100 mL ⁄ day, aminoglycoside, clindamycin or vancomycin can be substituted for cephalosporins.…”

mentioning

confidence: 99%

Pharmacokinetics of Clindamycin in the Plasma and Dialysate after Intraperitoneal Administration of Clindamycin Phosphoester to Patients on Continuous Ambulatory Peritoneal Dialysis: An Open‐Label, Prospective, Single‐Dose, Two‐Institution Study

Chang

Namgung

Choi

et al. 2012

Basic Clin Pharma Tox

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Abstract:We evaluated the pharmacokinetics of clindamycin and the dose of clindamycin phosphate necessary to treat peritonitis after intraperitoneal administration of clindamycin phosphate to patients on continuous ambulatory peritoneal dialysis (CAPD). This was an open-label, prospective, single-dose study conducted at the two levels of institutional clinical care in South Korea. Twelve patients (six men and six women; all older than 25 years), mean CAPD duration of 38.2 months with various origins without peritonitis, received 600 mg clindamycin phosphate mixed with only the first 2-L dialysate (1.5% dextrose). The 1.5%, 1.5%, 2.5% and 1.5% dextrose dialysates were serially exchanged every 6 hr. If patients were non-anuric, 24-hr urine samples were also collected. Clindamycin phosphate was incompletely activated to clindamycin in the dialysate. The clindamycin concentration in the dialysate was greater than the effective concentration (5 lg ⁄ mL) at 6.87 lg ⁄ mL up to 6 hr. So, 600 mg clindamycin phosphate per every 6 hr dialysate is effective for treatment of peritonitis. It has been reported that the clindamycin concentrations in the dialysate may be higher in CAPD patients with peritonitis. Thus, we can expect that intraperitoneal administration of <600 mg clindamycin phosphate per every 6 hr dialysate could be maintained over 5 lg ⁄ mL in patients with peritonitis. The transfer of clindamycin was unidirectional from the dialysate to the plasma.

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Adult Peritoneal Dialysis-Related Peritonitis Treatment Recommendations: 2000 Update

Cited by 371 publications

References 42 publications

Change in bacterial aetiology of peritoneal dialysis-related peritonitis over 10 years: experience from a centre in south-east Asia

Change in bacterial aetiology of peritoneal dialysis-related peritonitis over 10 years: experience from a centre in south-east Asia

Clinical effectiveness of different approaches to peritoneal dialysis catheter exit-site care

Pharmacokinetics of Clindamycin in the Plasma and Dialysate after Intraperitoneal Administration of Clindamycin Phosphoester to Patients on Continuous Ambulatory Peritoneal Dialysis: An Open‐Label, Prospective, Single‐Dose, Two‐Institution Study

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