Outcome of peritonitis treated with intraperitoneal (i.p.) weekly vancomycin and i.p. daily netilmicin

Area of Science:

• Nephrology
• Infectious Diseases
• Clinical Pharmacy

Background:

• Peritoneal dialysis (PD) related peritonitis requires effective empirical treatment.
• Vancomycin is often avoided due to rising vancomycin-resistant enterococci (VRE) concerns.
• Continuous ambulatory peritoneal dialysis (CAPD) peritonitis management guidelines are evolving.

Purpose of the Study:

• To evaluate the efficacy of vancomycin and netilmicin as empirical therapy for CAPD peritonitis.
• To assess the cure rate of this combined regimen in a clinical program.
• To highlight the importance of local resistance patterns in treatment decisions.

Main Methods:

• Retrospective analysis of CAPD peritonitis cases treated with vancomycin and netilmicin.
• Monitoring of treatment outcomes and cure rates.
• Consideration of local antimicrobial susceptibility data.

Main Results:

• A cure rate exceeding 80% was achieved with the vancomycin-netilmicin regimen.
• This combination demonstrated favorable outcomes in the studied CAPD program.
• The data supports continued use in specific local contexts.

Conclusions:

• Vancomycin and netilmicin remain an effective empirical therapy for CAPD peritonitis in settings with low VRE prevalence.
• Treatment strategies should be tailored based on local microbiological data, including VRE and staphylococcal sensitivity.
• Adherence to updated guidelines and local resistance patterns is crucial for optimizing PD peritonitis treatment.