Efficacy of a non-vancomycin-based peritoneal dialysis peritonitis protocol
- Resource Type
- Authors
- Hilton Gock; Brendan F. Murphy; Robyn G Langham; Jonathon Snider; Nigel Toussaint; Kim Mullins
- Source
- Nephrology. 10:142-146
- Subject
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Population
Peritonitis
Peritoneal dialysis
Vancomycin
Internal medicine
Cefazolin
Drug Resistance, Bacterial
Outpatients
medicine
Humans
Initial treatment
Prospective Studies
education
Aged
education.field_of_study
business.industry
General Medicine
Middle Aged
medicine.disease
Antimicrobial
Anti-Bacterial Agents
Surgery
Empirical treatment
Nephrology
Kidney Failure, Chronic
Drug Therapy, Combination
Female
Gentamicin
Gentamicins
business
Peritoneal Dialysis
Injections, Intraperitoneal
medicine.drug
- Language
- ISSN
- 1440-1797
1320-5358
SUMMARY: Background: Peritonitis has a significant impact upon morbidity and mortality of peritoneal dialysis (PD) patients. Gram-positive organisms account for the majority of infections and vancomycin is a cost effective broad-spectrum antimicrobial treatment for PD peritonitis, but this may lead to the emergence of multiple antibiotic-resistant organisms. The purpose of the present paper was to evaluate the efficacy of a non-vancomycin-based protocol comprising cephazolin and gentamicin, which was introduced in the present PD population as empirical treatment for peritonitis. Methods: The study involved 82 peritonitis episodes over a 4-year period in 58 patients, excluding those with previous methicillin-resistant staphylococcal peritonitis. Results: With cephazolin and gentamicin there was no apparent difference in response or relapse rates in comparison to reported studies using vancomycin-based first-line therapy protocols. Conclusion: We advocate initial treatment of PD peritonitis with non-vancomycin-based therapy given similar efficacy and the potential for reduction of resistant organisms.