The efficacy and systemic absorption of
netilmicin following intraperitoneal instillation were studied during ten episodes of clinical
peritonitis in
chronic renal failure patients managed by
CAPD. Episodes were unselected for sensitivity of microorganism in vitro to
netilmicin. Five subjects studied as inpatients had sequential
dialysate and frequent plasma samples assayed for netilimicin up to 110 hours of
therapy. Five patients who managed their
peritonitis at home had
dialysate and plasma
netilmicin levels estimated at two and six days. In a dose of 10 mg/l,
netilmicin was curative in the majority of patients (70%). Toxic blood levels were not found. Experience with
netilmicin compared favourably with that observed in eight consecutive episodes of outpatient
peritonitis managed with intraperitoneal
cefamandole, the first line treatment for
CAPD peritonitis in our unit (75% cure). No side effects were recorded with either agent. We conclude that
netilmicin can be used effectively in the majority of microbiologically undifferentiated episodes of
CAPD peritonitis, including in the home setting.