Antibiotic Lock in Tenckhoff Catheter for Biofilm-Associated Peritonitis

Biofilm bacteria in the Tenckhoff catheter are notoriously difficult to eradicate. They are the potential sources of relapsing or repeat peritonitis among peritoneal dialysis (PD) patients. Inadequate penetration into biofilms by standard intraperitoneal antibiotics, as well as a lack of effective adjunctive treatment, leads to a high rate of Tenckhoff catheter loss as a result of biofilm bacteria. In hemodialysis, on the other hand, catheter-related bloodstream infection caused by biofilm bacteria does not necessarily lead to a loss of catheter. Here, the use of antibiotic lock in conjunction with systemic antibiotics has been shown to be an effective treatment. In this case report, we present 2 cases of biofilm-associated PD peritonitis. The success in salvaging the Tenckhoff catheters by antibiotic lock suggested a potentially similar efficacy in PD patients using this adjunctive treatment, which has not been thoroughly investigated in the literature. Relevant clinical trials are necessary to evaluate whether antibiotic lock is also effective in eradicating biofilm bacteria in the Tenckhoff catheter.