Colonoscopy in Automated Peritoneal Dialysis Patients: Value of Prophylactic Antibiotics: A Prospective Study on a Single Antibiotic

Al-Hwiesh, Abdullah K; Abdul-Rahman, Ibrahiem Saeed; Hussameldeen, Mohammad A.; Al-Audah, Nadia; Abdelrahman, Abdalla; Moaigel, Hala M Al; El-Salamony, Tamer; Noor, Abdul-Salam; Al-Osail, Aisha M.; Al-Sayel, Dalai; Aldossari, Nourah Ali

doi:10.5301/ijao.5000612

Cited by 18 publications

(28 citation statements)

References 33 publications

(47 reference statements)

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“…However, the cited work included patients undergoing upper endoscopy and hysteroscopy as well as colonoscopy [14]. Moreover, previous studies could not identify factors contributing to colonoscopy-related peritonitis because of a small sample size [12, 14, 15]. In this multicentre study, we sought to identify factors associated with peritonitis and the effects of antibiotic prophylaxis in patients on PD undergoing colonoscopy.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for peritonitis in patients on continuous ambulatory peritoneal dialysis who undergo colonoscopy: a retrospective multicentre study

et al. 2019

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BackgroundColonoscopy is associated with a risk of peritonitis in patients on peritoneal dialysis. However, no study has yet described the risk factors in play.MethodsThis was a retrospective multicentre study. The medical records of patients on continuous ambulatory peritoneal dialysis (CAPD) who underwent colonoscopy from January 2003 to December 2012 were analysed. We recorded demographic characteristics, colonoscopic factors, use of prophylactic antibiotics, and development of peritonitis. Colonoscopy-related peritonitis was defined as peritonitis developing within 1 week after colonoscopy. Demographic and clinical characteristics were compared between patients who did and those who did not develop peritonitis.ResultsDuring the study period, 236 patients on CAPD underwent colonoscopy, of whom 9 (3.8%) developed peritonitis. The rates of polypectomy/endoscopic mucosal resection were significantly higher in the peritonitis group than in the no peritonitis group (66.7 vs. 23.4%, p = 0.009). Prophylactic antibiotics were prescribed before colonoscopy in 65 patients; none developed peritonitis. No patient who developed peritonitis received prophylactic antibiotics (p = 0.067).ConclusionsAdvanced procedures including polypectomy or endoscopic mucosal resection increase colonoscopy-related peritonitis in patients on CAPD. Randomized controlled trials to investigate whether prophylactic antibiotics are needed to prevent peritonitis in all CAPD patients are warranted.

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Section: Introductionmentioning

confidence: 99%

Risk factors for peritonitis in patients on continuous ambulatory peritoneal dialysis who undergo colonoscopy: a retrospective multicentre study

et al. 2019

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“…[14] Moreover, previous studies could not identify factors contributing to colonoscopyrelated peritonitis because of a small sample size. [12,14,15] In this multicentre study, we sought to identify factors associated with peritonitis and the effects of antibiotic prophylaxis in patients on PD undergoing colonoscopy. Peritonitis was diagnosed when at least two of the following criteria were met: (1) abdominal pain with or without a cloudy dialysis effluent, (2) a peritoneal effluent white cell count >100/μL with >50% polymorphonuclear neutrophils, and (3) a positive dialysis effluent culture.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for peritonitis in patients on continuous ambulatory peritoneal dialysis who undergo colonoscopy: A retrospective multicentre study

Gweon

Jung

Kim

et al. 2019

Preprint

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Background: Colonoscopy is associated with a risk of peritonitis in patients on peritoneal dialysis. However, no study has yet described the risk factors in play. Methods: This was a retrospective multicentre study. The medical records of patients on continuous ambulatory peritoneal dialysis (CAPD) who underwent colonoscopy from January 2003 to December 2012 were analysed. We recorded demographic characteristics, colonoscopic factors, use of prophylactic antibiotics, and development of peritonitis. Colonoscopy-related peritonitis was defined as peritonitis developing within 1 week after colonoscopy. Demographic and clinical characteristics were compared between patients who did and those who did not develop peritonitis. Results: During the study period, 236 patients on CAPD underwent colonoscopy, of whom 9 (3.8%) developed peritonitis. The rates of polypectomy/endoscopic mucosal resection were significantly higher in the peritonitis group than in the no peritonitis group (66.7 vs. 23.4%, p=0.009). Prophylactic antibiotics were prescribed before colonoscopy in 65 patients; none developed peritonitis. No patient who developed peritonitis received prophylactic antibiotics (p=0.067). Conclusions: Advanced procedures including polypectomy or endoscopic mucosal resection increase colonoscopy-related peritonitis in patients on CAPD. Prophylactic antibiotics should be administered before colonoscopy to such patients.

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“…Kidney transplant candidates, in particular, continue to be screened for colorectal cancer as well, a disproportionate percentage of whom are on PD as a dialysis modality [30]. There is growing literature that colonoscopy increases the risk of peritonitis in the PD population [32-34]. Mucosal disruption and subsequent seeding of the peritoneum is the most frequently proposed mechanism [25, 32].…”

Section: Colonoscopymentioning

confidence: 99%

Periprocedural Peritonitis Prophylaxis: A Summary of the Microbiology and the Role of Systemic Antimicrobials

Hsueh

Shah

2021

Kidney Dis

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Background: Peritonitis is a leading complication of peritoneal dialysis (PD). One strategy that the International Society for Peritoneal Dialysis (ISPD) has used to help mitigate the morbidity and mortality associated with peritonitis is through prevention, including antibiotic prophylaxis utilization in high-risk situations. The aim of this study is to summarize our current understanding of postprocedural peritonitis and discuss the existing data behind periprocedural antibiotic prophylaxis, focusing primarily on PD catheter insertion, dental procedures, colonoscopies, upper endoscopies with gastrostomy, and gynecologic procedures. Summary: The ISPD currently recommends intravenous antibiotics prior to PD catheter insertion, colonoscopies, and invasive gynecologic procedures, though prophylaxis has only demonstrated benefit in a prospective, randomized control setting for PD catheter insertion. However, multiple retrospective studies exist that support the use of antibiotic prophylaxis for the other 2 procedures. No specific antibiotic regimen has been established as most optimal to prevent peritonitis for any of the 3 procedures. Antibiotic coverage should include the Enterobacteriaceae family, as well as Gram-positive organisms commonly found on the skin flora for PD catheter insertion, anaerobes for colonoscopies, and common organisms from the urogenital flora in gynecologic procedures. Additionally, the ISPD currently recommends oral amoxicillin prior to dental procedures. There is currently no ISPD recommendation to provide antibiotic prophylaxis prior to an upper endoscopy with or without gastrostomy, though this is a potential area for research. Key Messages: PD patients are at high risk for developing peritonitis after typical procedures. Antibiotic prophylaxis is a potential strategy that the ISPD utilizes to prevent these infections. However, further research needs to be done to determine the optimal antibiotic regimen.

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Colonoscopy in Automated Peritoneal Dialysis Patients: Value of Prophylactic Antibiotics: A Prospective Study on a Single Antibiotic

Abstract: The relation between prophylactic antibiotic use prior to colonoscopy in APD patients and the risk of peritonitis was lacking. Only diabetes mellitus appears to be of significance. Polypectomy did not increase peritonitis episodes.

Cited by 18 publications

References 33 publications

Risk factors for peritonitis in patients on continuous ambulatory peritoneal dialysis who undergo colonoscopy: a retrospective multicentre study

Risk factors for peritonitis in patients on continuous ambulatory peritoneal dialysis who undergo colonoscopy: a retrospective multicentre study

Risk factors for peritonitis in patients on continuous ambulatory peritoneal dialysis who undergo colonoscopy: A retrospective multicentre study

Periprocedural Peritonitis Prophylaxis: A Summary of the Microbiology and the Role of Systemic Antimicrobials

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