Once-daily intraperitoneal gentamicin is effective therapy for gram-negative CAPD peritonitis.

Abstract

OBJECTIVE:

To report our 3-year experience with the use of once-daily intraperitoneal (IP) gentamicin in the treatment of gram-negative continuous ambulatory peritoneal dialysis (CAPD) peritonitis.

DESIGN:

A prospective cohort study in prevalent CAPD patients.

SETTING:

A tertiary care institution.

PATIENTS:

All CAPD patients who presented with new episodes of peritonitis were studied. At presentation with peritonitis, IP vancomycin and gentamicin were administered as empirical therapy. IP gentamicin was given at a single daily dose of 40 mg/2 L in the overnight bag. The antimicrobial agents were reviewed when the culture results became available. Intraperitoneal ceftazidime was added for the treatment of pseudomonas peritonitis.

MAIN OUTCOME MEASURES:

Results of microbiological cultures and clinical outcomes of peritonitis were analyzed.

RESULTS:

Over a 36-month period, 190 episodes of peritonitis were recorded, of which 62/190 episodes (32.6%) isolated gram-negative organisms. The gram-negative organisms isolated were Escherichia coli, 15/62 episodes (24.1%); Pseudomonas aeruginosa, 12/62 episodes (19.4%); Acinetobacter spp, 12/62 episodes (19.4%); Klebsiella spp, 10/62 episodes (16.1%); and others, 13/62 episodes (21.0%). The overall treatment success rate was 66.1%. The treatment success rates were 74.0% if pseudomonas infections were excluded, 76.1% if gentamicin-resistant pathogens were excluded, and 80.5% if both pseudomonas infections and gentamicin-resistant pathogens were excluded.

CONCLUSIONS:

Once-daily IP gentamicin appears to be effective in the treatment of gram-negative CAPD peritonitis.

• Authors: W C Lye, J C van der Straaten, S O Leong, P Sivaraman, S H Tan, C C Tan, E J Lee
• Journal: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis (Perit Dial Int) 1999 Jul-Aug Vol. 19 Issue 4 Pg. 357-60 ISSN: 0896-8608 [Print] United States
• PMID: 10507817 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Gentamicins

Topics

• Anti-Bacterial Agents (administration & dosage)
• Drug Administration Schedule
• Female
• Gentamicins (administration & dosage)
• Humans
• Male
• Middle Aged
• Peritoneal Dialysis, Continuous Ambulatory (adverse effects)
• Peritonitis (drug therapy, etiology, mortality)
• Prospective Studies
• Recurrence
• Treatment Failure