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Oral pefloxacin in the treatment of CAPD peritonitis
Abstract:
Continuous ambulatory peritoneal dialysis (CAPD), a widely used replacement therapy for end stage renal failure, is frequently complicated by bacterial peritonitis. The infecting organisms are mainly staphylococci and gram negative aerobes. Pefloxacin is a fluorinated quinolone with good in-vitro activity against these pathogens. The objective of this open non comparative study is to determine the effectiveness and safety of oral pefloxacin mesylate as a single first line antimicrobial treatment of CAPD peritonitis. 28 episodes of CAPD peritonitis were treated with a stat dose of pefloxacin 800 mg. followed by 400 mg. 12 hourly for about 15-18 days. A pefloxacin sensitive organism was isolated in 17 episodes. 11 episodes were culture negative. Treatment results showed a cure in seventeen (60.7%), no treatment response in seven (25%), and relapses in four (14.2%). Side effects encountered were not serious except for one incident of a generalized seizure. We conclude that oral pefloxacin is convenient, safe and effective enough as a single first line antimicrobial treatment for CAPD peritonitis.
Insights
Oral pefloxacin effectively treats bacterial peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients. This study found pefloxacin to be a safe and convenient first-line option for CAPD peritonitis, with a 60.7% cure rate.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Bacterial peritonitis is a common complication of continuous ambulatory peritoneal dialysis (CAPD).
- Staphylococci and Gram-negative aerobes are the primary causative agents of CAPD peritonitis.
- Pefloxacin exhibits potent in-vitro activity against common CAPD peritonitis pathogens.
Purpose of the Study:
- To evaluate the efficacy and safety of oral pefloxacin mesylate as a monotherapy for CAPD peritonitis.
- To establish pefloxacin as a potential first-line antimicrobial treatment for CAPD-associated infections.
Main Methods:
- An open, non-comparative study involving 28 episodes of CAPD peritonitis.
- Treatment involved a loading dose of pefloxacin 800 mg, followed by 400 mg every 12 hours for 15-18 days.
- Cultures were obtained, and treatment outcomes (cure, no response, relapse) were assessed.
Main Results:
- A causative organism sensitive to pefloxacin was identified in 17 episodes; 11 episodes were culture-negative.
- A cure was achieved in 17 episodes (60.7%), with 7 episodes (25%) showing no treatment response and 4 (14.2%) experiencing relapse.
- Adverse events were generally mild, with one instance of a generalized seizure reported.
Conclusions:
- Oral pefloxacin demonstrates convenience, safety, and sufficient effectiveness as a single first-line treatment for CAPD peritonitis.
- Pefloxacin represents a viable therapeutic option for managing bacterial peritonitis in patients undergoing CAPD.