Abstract
Objective
We determined the effectiveness of a once-daily cefazolin-based regimen in treating automated peritoneal dialysis (APD) peritonitis.
Design
We carried out a retrospective analysis of all APD peritonitis episodes treated with a once-daily cefazolin protocol.
Setting
The study was performed in a peritoneal dialysis unit in a tertiary care hospital.
Patients and Methods
We studied 60 episodes of primary peritonitis in 40 patients on APD. Each patient was treated with a vancomycin-free regimen consisting of intraperitoneal cefazolin (1.5 g IP) with gentamicin IP administered in the daytime exchange. The main outcome measures were successful treatment of peritonitis, removal of peritoneal catheter, relapse of peritonitis, and patient death.
Results
Gram-positive infections occurred in 35 episodes (58.3%), gram-negative infections in 10 episodes (16.7%), culture-negative infections in 14 episodes (23.3%), and a yeast infection in 1 episode (1.7%). Of the 60 episodes, 47 (78.3%) were successfully treated. In 10 episodes (16.7%), catheters were removed (9 for treatment failure, 1 for yeast infection). Four patients (8%) had a relapse of infection within 4 weeks of completing antibiotic therapy. One patient (1.7%) died.
Conclusions
Our results demonstrate that once-daily cefazolin with gentamicin IP is an effective treatment for APD peritonitis, with the advantage of being easy to administer and enabling patients to remain on APD during treatment.
Get full access to this article
View all access options for this article.