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Effective treatment of peritoneal dialysis-associated peritonitis with cefazolin and ceftazidime in children

E Rusthoven1, L A Monnens, C H Schröder

  • 1Department of Pediatrics, Wilhelmina Children's University Hospital, Utrecht, The Netherlands. e.rusthoven@wkz.azu.nl

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|October 6, 2001
PubMed

Insights

The combination of cefazolin and ceftazidime effectively treats pediatric peritoneal dialysis (PD)-related peritonitis. This antibiotic regimen avoids toxic complications often seen with other treatments.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Pharmacology

Background:

  • Peritonitis is a common complication in children undergoing peritoneal dialysis (PD).
  • Effective and safe initial antibiotic therapy for PD-related peritonitis is crucial in pediatric patients.
  • Alternative antibiotic regimens may carry significant toxicities.

Purpose of the Study:

  • To evaluate the efficacy and safety of a combined cefazolin and ceftazidime regimen for the initial treatment of PD-related peritonitis in children.
  • To assess the cure rates and recurrence of peritonitis episodes.
  • To determine if this combination avoids the toxic complications associated with aminoglycosides.

Main Methods:

  • A retrospective, nonrandomized study was conducted across two Dutch pediatric dialysis units.
  • Medical records of 40 children experiencing 50 episodes of PD-related peritonitis were reviewed.
  • Patients received intraperitoneal cefazolin and ceftazidime for 14 days, with dosage adjustments based on microorganism identification.

Main Results:

  • All peritonitis episodes (50) showed initial clinical cure within 3 days.
  • A 10% recurrence rate was observed within two weeks post-treatment.
  • Four cases of Pseudomonas-related peritonitis were successfully treated with this regimen.

Conclusions:

  • The combination of cefazolin and ceftazidime is an effective initial treatment for pediatric PD-related peritonitis.
  • This regimen offers a favorable alternative by avoiding the toxicities associated with aminoglycosides.
  • The treatment demonstrated high initial cure rates and successful management of challenging infections like Pseudomonas.
Abstract

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