Our protocol in the treatment of peritonitis in patients on continuous ambulatory peritoneal dialysis

1996 
: Peritonitis is a very serious complication in patients treated by CAPD. The frequent and grave episodes are the main cause for CAPD withdrawal. The effective prevention and adequate therapy of peritonitis are very important for a successful CAPD treatment. The aim of this study was to present our results of peritonitis therapy in CAPD patients using the following protocol: Vancomycin 1.0 g.i.p. immediately after the admission to the unit, 250 mg Ceftriaxon (Longaceph) after a bag exchange for seven days, and the 1.0 g Vancomycin. Using this protocol we treated 97 peritonitis episodes; 74 of them (80%) were treated successfully by this antibiotics combination. The clearness of peritoneal fluid was attained 1-3 days within 56.7% of cases, and 4-6 days within the 29.7% peritonitis episodes (86.4%). A common cause of peritonitis was Staphylococcus epidermidis episodes (28.4%), Staphylococcus aureus (13.5%), and in 39.1% episodes the cultures were sterile. Uneffective antibiotic application according to this protocol was found in cases of pseudomonas and fungal peritonitis. The mentioned antibiotic therapy had no effect in a small number of peritonitides provoked by S. epidermidis (8.7%) and S. aureus (13.0%) This required the application of a third antibiotic. It could be concluded that this antibiotic combination in treatment of peritonitis in patients on CAPD was very effective.
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