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Efficacy of vancomycin plus tobramycin as antiperitonitis regimen for patients on CAPD
V Vargemezis1, E Thodis, P Pasadakis
1Democritus University of Thrace, General District Hospital, Alexadroupolis, Greece.
Abstract:
From October 1985 to August 1989, 55 episodes of peritonitis were treated with intraperitoneal (i.p.) use of Vancomycin (V) and Tobramycin (T), in 35 patients (18 males, 17 females). After three rapid IL peritoneal exchanges, the pts received i.p. loading dose of V500 mg/L and an intramuscular dose of T 1.7 mg/Kg, followed by four IL exchanges, with addition of V15 mg/L and T8 mg/L. The length of treatment was 10 days for all pts. The continued administration of V or T as the simple antibiotic regimen was based on the antibiogram, while the combination of both antibiotics was used in negative cultures. Recurrence of peritonitis was seen in 3 episodes (5.4%). No side effects were seen during the therapy. These results indicate that the i.p. use of Vancomycin plus Tobramycin are an appropriate antiperitonitis regimen in the treatment of CAPD peritonitis.
Insights
Intraperitoneal Vancomycin and Tobramycin effectively treated peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients. This antibiotic regimen demonstrated a low recurrence rate and no observed side effects, indicating its suitability for CAPD peritonitis management.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Peritonitis is a significant complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
- Effective antibiotic treatment is crucial for managing CAPD-related peritonitis and preventing recurrence.
Purpose of the Study:
- To evaluate the efficacy and safety of intraperitoneal Vancomycin and Tobramycin for treating CAPD peritonitis.
- To determine the recurrence rate and side effects associated with this combined antibiotic regimen.
Main Methods:
- A total of 55 episodes of peritonitis in 35 CAPD patients were treated between October 1985 and August 1989.
- The treatment involved intraperitoneal (i.p.) administration of Vancomycin and Tobramycin, with specific loading and maintenance doses over a 10-day period.
- Antibiotic selection (Vancomycin, Tobramycin, or both) was guided by antibiogram results and culture findings.
Main Results:
- A low recurrence rate of peritonitis was observed in 3 out of 55 episodes (5.4%).
- No adverse side effects were reported during the course of the antibiotic therapy.
- The combined regimen showed effectiveness in clearing infections and preventing relapse.
Conclusions:
- Intraperitoneal Vancomycin and Tobramycin represent an appropriate and safe anti-peritonitis regimen for CAPD patients.
- This therapeutic approach offers a favorable outcome with minimal risk of recurrence and side effects.
- The study supports the use of this combination therapy in the clinical management of CAPD peritonitis.