Cefazolin plus netilmicin versus cefazolin plus ceftazidime for treating CAPD peritonitis: Effect on residual renal function

Lui, Sing Leung; Cheng, Suk Wai; Ng, Flora; Ng, Suk Yi; Wan, Kit Mui; Yip, Terence; Tse, Kai Chung; Lam, Man Fai; Lai, Kar Neng; Lo, Wai Kei

doi:10.1111/j.1523-1755.2005.00700.x

Cited by 58 publications

(47 citation statements)

References 18 publications

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“…Four clinical findings were selected as statistically significant variables using the stepwise method, and exit-site tunnel infection and frequency of past peritonitis were significantly associated with withdrawal from PD treatment by logistic regression analysis [14] include use of combination antibiotics, such as vancomycin or cephalosporin along with third-generation cephalosporins, including CAZ, or aminoglycosides, to cover Gram-positive and Gram-negative organisms, respectively. This recommendation was introduced based on the efficacy results of a randomized controlled study of use of the combination CEZ and CAZ for empirical treatment [15]. Prolonged therapy with vancomycin may predispose to infections with vancomycin-resistant S. aureus (VRSA) or vancomycin-resistant enterococci (VRE).…”

Section: Discussionmentioning

confidence: 99%

Peritonitis in peritoneal dialysis patients in Japan: a 2013 retrospective questionnaire survey of Japanese Society for Peritoneal Dialysis member institutions

et al. 2016

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Background: Peritonitis is the main cause of withdrawal from peritoneal dialysis (PD) therapy in Japan. The precise extent of PD-associated peritonitis in Japan has not been investigated since 2005; we aimed to clarify the recent incidence and prognosis of PD peritonitis. Methods: The 248 institutional members of the Japanese Society for Peritoneal Dialysis were surveyed by questionnaire regarding peritonitis episodes during January 1 to December 31, 2013. Results: Replies from 114 members were received regarding 3042 PD patients, including 516 peritonitis patients, covering a total observation period of 31,686 patient months. The incidence of peritonitis in this study was 0.195 episodes per year. Detailed data on 544 peritonitis episodes in 466 patients was obtained. The causes, in ranked order, were unknown reason, contamination at peritoneal fluid exchange, and extension of intra-abdominal cavity infection. Effluent culture methods included using a blood culture bottle (50.9 %), large-volume culture (culturing sediment after centrifuging effluent) (31.7 %), and direct culture of effluent using a culture dish (12.7 %). The rank order of microbes identified in peritoneal effluent cultures was culture-negative, Streptococcus sp. and Staphylococcus aureus. Empiric therapy with two kinds of antibiotics was administered to 406 cases (75.2 %), most commonly cefazolin + ceftazidime. Antibiotic administration methods included intraperitoneal (51.4 %), intravenous (46.4 %), and oral (2.2 %). After a peritonitis episode, 461 patients (84.7 %) continued PD therapy, 80 (14.7 %) withdrew from PD treatment, and 6 (1.1 %) died. Prognosis among patients grouped by antibiotic administration method was statistically significantly different; in the oral administration group, the rates of mortality and catheter replacement were higher. Logistic regression analysis showed that catheter exit-site infection and frequency of past peritonitis episodes were independent factors associated with PD treatment withdrawal. Conclusions: Although the overall incidence of PD peritonitis in Japan was relatively low, several areas for future improvement were identified: unknown reason and culture-negative were the most frequently cited causes of peritonitis; 1.1 % of patients died, and 13.6 % discontinued PD therapy. Improvements in effluent culture techniques, antibiotic administration methods, etiology determination, and patient education could help. A more effective protocol must be established to further improve the treatment of PD peritonitis in Japan.

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Section: Discussionmentioning

confidence: 99%

Peritonitis in peritoneal dialysis patients in Japan: a 2013 retrospective questionnaire survey of Japanese Society for Peritoneal Dialysis member institutions

et al. 2016

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“…Therefore, if a center's gram-negative resistance to ceftazidime exceeds 10%, an aminoglycoside should be used, provided that its gram-negative resistance rate is lower. Studies have shown that, in terms of complete cure, treatment failure, and its effect on residual renal function, empiric intraperitoneal administration of cefazolin-netilmycin did not differ from that of cefazolin-ceftazidime (192). However, extended courses of aminoglycoside therapy are associated with vestibular and ototoxicity and potential loss of residual kidney function, mandating the discontinuation of empiric aminoglycosides once susceptibilities are known and an alternative antibiotic to which the organism will respond is available (193).…”

Section: Guideline 103mentioning

confidence: 99%

Consensus Guidelines for the Prevention and Treatment of Catheter-Related Infections and Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis: 2012 Update

et al. 2012

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“…It was reported that peritonitis was a risk factor for RRF decline in PD patients [9-11], whereas some other studies did not prove this phenomenon [12, 13]. Kim JK et al found that excessive weight gain during the first year was correlated with RRF loss [14], however some other findings did not support this observation [15, 16].…”

Section: Introductionmentioning

confidence: 50%

A Fast Decline of Residual Renal Function in the First Year is a Predictor for Early Withdrawal from Peritoneal Dialysis in Non-Diabetic Patients

Xie

Yan

Yang

et al. 2019

Kidney Blood Press Res

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Background/Aims: Little is known about the relationship between residual renal function (RRF) decline in early period and survival in non-diabetic peritoneal dialysis (PD) patients. Methods: A total of 567 non-diabetic patients who began PD from January 1, 2005 to June 30, 2013 was investigated. The rate of RRF decline was determined by the “slope of the trend equation” of serial RRFs. A composite end-point of all-cause mortality and conversion to hemodialysis (HD) was used, survival status was censored on June 30, 2016. Results: The median of “the slope of RRF decline equation” was 0.308 (0.001-2.111) ml/min/1.73 m2/ month. In the median follow-up period of 43 months (range 12 to 120 months), 65 (11.5%) patients died, 90 (15.9%) patients converted to HD and 171 (30.2%) patients received kidney transplantation. Multivariate linear regression showed male, high baseline RRF, high baseline peritoneal Kt/V urea, low serum albumin and low uric acid were independently associated with the rate of RRF decline in the first year of PD. Multivariate Cox models revealed that RRF decline in the first year remained a predictor for composite end-point (HR, 2.74, 95% CI, 1.53 to 4.90, P=0.001). The patients were divided into high RRF decline group (> 0.308ml/ min/1.73m2/month) and low RRF decline group (≤0.308 ml/min/1.73m2/month). In the first three years of PD, the rate of end-point events was higher in high RRF decline group (23.2%) than that in low RRF decline group (11.0%) (P< 0.001). There were 189 patients in low RRF decline group and 171 patients in high RRF decline group maintaining PD for more than 3 years, in a median follow-up of 54 months (range 37 to 120 months), the survival rate was 30.9% in high RRF decline group and 46.4% in low RRF decline group (P=0.883). In high RRF decline group, there were 92 patients reaching composited end-point and 112 patients maintaining PD; multivariate Cox model showed high peritoneal Kt/V urea after 1 year of PD and high albumin level were protective factors (HR, 0.29, 95% CI, 0.13 to 0.61, P= 0.001; HR, 0.94, 95% CI, 0.90-0.99, P=0.022, respectively), while fast RRF decline remained risk factor for composite end-point (HR, 3.28, 95% CI,1.48-7.31, P=0.004). Conclusion: A faster RRF decline in the first year was a predictor for all-cause mortality and conversion to HD in non-diabetic PD patients, mainly in the first three year. For patients with faster RRF decline, increasing PD dose was effective to improve survival.

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Cefazolin plus netilmicin versus cefazolin plus ceftazidime for treating CAPD peritonitis: Effect on residual renal function

Cited by 58 publications

References 18 publications

Peritonitis in peritoneal dialysis patients in Japan: a 2013 retrospective questionnaire survey of Japanese Society for Peritoneal Dialysis member institutions

Peritonitis in peritoneal dialysis patients in Japan: a 2013 retrospective questionnaire survey of Japanese Society for Peritoneal Dialysis member institutions

Consensus Guidelines for the Prevention and Treatment of Catheter-Related Infections and Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis: 2012 Update

A Fast Decline of Residual Renal Function in the First Year is a Predictor for Early Withdrawal from Peritoneal Dialysis in Non-Diabetic Patients

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