Randomized controlled trial of prophylactic rifampin for peritoneal dialysis-related infections.

Abstract

Staphylococcal infections are a major cause of catheter infections and peritonitis in peritoneal dialysis patients. Since catheter-related infections are associated with nasal carriage of Staphylococcus aureus in this population, we studied the effect of intermittent rifampin, an antibiotic known to decrease S aureus nasal carriage, on catheter-related infections and peritonitis. We randomly assigned 64 patients to receive either rifampin 300 mg twice daily for 5 days every 3 months or no treatment. The rifampin-treated patients had a significant delay in time to first catheter-related infection (P less than 0.015) and significantly fewer catheter-related infections overall (P less than 0.001). The catheter-related infection rate in rifampin-treated patients was .26 per patient-year versus .93 per patient-year in untreated patients. Multivariate analysis defined baseline colonization of nares or catheter exit-site and prior renal transplant as risk factors for catheter-related infections. There was no significant difference in peritonitis rates between groups, although the trend was for a delayed time to first episodes and fewer episodes in rifampin-treated patients. Adverse effects necessitated withdrawal of rifampin in four patients. We conclude that intermittent rifampin administration is effective in decreasing catheter-related infections in a peritoneal dialysis population.

• Authors: S W Zimmerman, E Ahrens, C A Johnson, W Craig, J Leggett, M O'Brien, L Oxton, E B Roecker, S Engeseth
• Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 18 Issue 2 Pg. 225-31 (Aug 1991) ISSN: 0272-6386 [Print] United States
• PMID: 1867179 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Rifampin

Topics

• Adult
• Bacteriological Techniques
• Catheters, Indwelling
• Data Interpretation, Statistical
• Female
• Humans
• Male
• Middle Aged
• Peritoneal Dialysis, Continuous Ambulatory (adverse effects)
• Peritonitis (etiology, microbiology, prevention & control)
• Rifampin (therapeutic use)
• Staphylococcal Infections (prevention & control)
• Staphylococcus aureus (growth & development)