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How should peritoneal-dialysis-associated peritonitis be treated?

Beth Piraino¹, Filitsa Bender

¹Renal Electrolyte Division, The University of Pittsburgh School of Medicine, 3504 Fifth Avenue, Suite 3504, Pittsburgh, PA 15213, USA. piraino@pitt.edu

Nature Clinical Practice. Nephrology

|May 22, 2008

Summary

Peritonitis treatment in peritoneal dialysis patients shows most antibiotics are effective. Intraperitoneal administration and glycopeptide regimens appear more successful than intravenous routes and cephalosporins, highlighting the need for more research.

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Area of Science:

Nephrology
Infectious Diseases
Peritoneal Dialysis

Background:

Peritonitis is a significant complication for patients undergoing peritoneal dialysis.
Existing data on optimal peritonitis treatment is limited and often lacks robust evidence.

Discussion:

This commentary reviews a systematic review on peritonitis treatment in peritoneal dialysis.
It highlights findings regarding antibiotic efficacy, administration routes, dosing, and specific drug classes.

Key Insights:

Intraperitoneal antibiotic administration demonstrated higher efficacy than intravenous routes.
Intermittent antibiotic dosing was as effective as continuous administration.
Glycopeptide-based regimens were associated with higher cure rates compared to first-generation cephalosporins.

Outlook:

There is an urgent need for large, well-designed randomized controlled trials to establish definitive treatment guidelines.
Further research is crucial to optimize peritonitis management and improve patient outcomes in peritoneal dialysis.