Related Experiment Videos
Cefazolin plus netilmicin versus cefazolin plus ceftazidime for treating CAPD peritonitis: effect on residual renal
Sing Leung Lui1, Suk Wai Cheng, Flora Ng
1Division of Nephrology, University Department of Medicine, Tung Wah Hospital, Hong Kong SAR, People's Republic of China. sllui@hku.hk
Kidney International
|October 14, 2005
Summary
Cefazolin plus netilmicin and cefazolin plus ceftazidime show similar efficacy for treating continuous ambulatory peritoneal dialysis (CAPD) peritonitis. Residual renal function (RRF) reduction is reversible with both antibiotic regimens, but routine use of cefazolin and ceftazidime is not supported.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- The International Society for Peritoneal Dialysis (ISPD) guidelines recommend cefazolin plus ceftazidime for continuous ambulatory peritoneal dialysis (CAPD) peritonitis in patients with residual renal function (RRF).
- This recommendation has not been prospectively compared against the conventional cefazolin plus netilmicin regimen in randomized controlled trials.
Purpose of the Study:
- To compare the efficacy of intraperitoneal (i.p.) cefazolin plus netilmicin versus cefazolin plus ceftazidime as empirical therapy for CAPD peritonitis.
- To assess the impact of these antibiotic regimens on RRF and 24-hour urine volume in CAPD patients with RRF.
Main Methods:
- A randomized controlled trial involving stable CAPD patients with peritonitis.
- Patients received either i.p. cefazolin plus netilmicin or cefazolin plus ceftazidime once daily for 14 days.
- RRF and 24-hour urine volume were measured in patients with RRF at baseline, day 14, and day 42.
Main Results:
- Both regimens achieved similar primary cure rates (66.7% for cefazolin/netilmicin vs. 64.7% for cefazolin/ceftazidime) and overall cure rates (82.3% for both).
- Catheter removal due to treatment failure occurred in 14% of patients in each group; relapse rates were 4% for both.
- In patients with RRF, a significant but reversible reduction in RRF and urine volume was observed at day 14, returning to near baseline by day 42, with no significant difference between the groups.
Conclusions:
- Intraperitoneal cefazolin plus netilmicin and cefazolin plus ceftazidime demonstrate comparable efficacy for empirical CAPD peritonitis treatment.
- Successful antibiotic treatment can lead to significant, yet reversible, reductions in RRF and urine volume in CAPD patients with RRF.
- The study does not support the routine use of cefazolin and ceftazidime for empirical CAPD peritonitis treatment due to similar outcomes and potential impact on RRF.