Oral treatment of CAPD-peritonitis with ciprofloxacin.

Abstract

Peritonitis is still a major problem in CAPD. The synthetic chemotherapeutic quinolone ciprofloxacin offers new possibilities for oral treatment of this complication. The efficacy of ciprofloxacin as first-line antibiotic was investigated in five consecutive peritonitis episodes of five patients. The dosage was deduced from a pilot study and consisted of an intra-peritoneal loading dose during the first 24 hours. Simultaneously ciprofloxacin was given orally and thereafter only the oral medication was continued. The causative microorganisms in the 5 episodes were (MIC90 in brackets): nonfermentative Gram negative rod, group IVc-2 (0.6 micrograms/ml), S. aureus (0.25 micrograms ml), Strep. faecalis (0.4 micrograms/ml), S. aureus + S. epidermidis (both 0.25 micrograms/ml) and S. aureus (0.13 micrograms/ml). The clinical course was uncomplicated and all episodes were cured with ciprofloxacin monotherapy. In 4 patients all dialysate concentrations exceeded 2.3 micrograms/ml (mean 5.8 micrograms/ml). In one patient dialysate concentrations varied between 2.2 and 7.5 micrograms/ml during the first 24 hrs and between 0.4 and 1.2 micrograms/ml thereafter. Despite these low dialysate concentrations, the episode caused by S. aureus (MIC90 0.25 micrograms/ml) was cured uneventfully. We conclude that ciprofloxacin may be useful for the treatment of CAPD peritonitis. Large interindividual differences in dialysate concentrations should be taken into account.

• Authors: E W Boeschoten, E J Kuijper, P Speelman, D G Struijk, R T Krediet, L Arisz
• Journal: Advances in peritoneal dialysis. Conference on Peritoneal Dialysis (Adv Perit Dial) Vol. 6 Pg. 126-9 ( 1990) ISSN: 1197-8554 [Print] Canada
• PMID: 1982789 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Ciprofloxacin

Topics

• Administration, Oral
• Ciprofloxacin (administration & dosage, therapeutic use)
• Drug Evaluation
• Humans
• Peritoneal Dialysis, Continuous Ambulatory (adverse effects)
• Peritonitis (drug therapy)
• Staphylococcal Infections (drug therapy)