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Intraperitoneal Antibiotic Utilization among Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients with
Mastura Ahmad1, Che Suraya Zin1, Ab Fatah Ab Rahman2
1Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.
Introduction:
Patients receiving continuous ambulatory peritoneal dialysis (CAPD) are commonly associated with peritonitis. However, little is known about the utilization of antibiotics for the treatment of peritonitis in these patients.
Objectives:
This study aimed to evaluate the patterns of intraperitoneal (IP) antibiotic utilization for the treatment of peritonitis in CAPD patients.
Materials And Methods:
This is a retrospective study conducted at a tertiary hospital setting in Malaysia. Medical records of CAPD patients who were diagnosed with peritonitis and registered with National Kidney Registry from 2013 to 2018 were reviewed. Types of antibiotics used and its dose and duration were recorded and reported using the anatomical therapeutic chemical/defined daily dose (ATC/DDD) system.
Results:
A total of 105 peritonitis episodes were recorded from 72 patients. The most common first-line empirical antibiotic combinations used were ceftazidime/cefazolin (40%, n = 42), followed by cefepime/cefazolin (30.5%, n = 32) and ceftazidime/cloxacillin (25.7%, n = 27). The definitive therapy for culture-proven CAPD-related peritonitis (CAPD-P) showed that vancomycin was the most frequently prescribed antibiotic (31.7%, n = 26/82), followed by amikacin (14.6%, n = 12/82), meropenem (11%, n = 9/82) and ampicillin (11%, n = 9/82). Ciprofloxacin was among the least prescribed definitive antibiotics for CAPD-P (2.4%, n = 2/82) but the DDD/100 patient-days estimates showed that it had the highest therapeutic intensity.
Conclusion:
There are various IP antibiotics used for CAPD-P and the most common empirical therapy was the combination of ceftazidime and cefazolin while vancomycin is predominantly used for definitive therapy. Future studies to evaluate the clinical outcomes of the antibiotic use should be conducted to have a better insight on the efficacy of the peritonitis treatment.
Insights
This study analyzed antibiotic use for peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients. Ceftazidime/cefazolin was common empirical treatment, while vancomycin dominated definitive therapy for CAPD-related peritonitis.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Peritonitis is a common complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
- Understanding antibiotic utilization patterns is crucial for effective peritonitis management in CAPD patients.
Purpose of the Study:
- To evaluate the patterns of intraperitoneal (IP) antibiotic utilization for treating peritonitis in CAPD patients.
- To analyze antibiotic types, doses, and durations used in CAPD peritonitis cases.
Main Methods:
- Retrospective study of CAPD patients diagnosed with peritonitis from 2013-2018 in a Malaysian tertiary hospital.
- Medical records were reviewed to document antibiotic prescriptions.
- Antibiotic data were analyzed using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) system.
Main Results:
- 105 peritonitis episodes were analyzed from 72 patients.
- Ceftazidime/cefazolin was the most frequent empirical antibiotic combination (40%).
- Vancomycin was the most common definitive antibiotic for culture-proven CAPD peritonitis (31.7%), despite ciprofloxacin showing higher therapeutic intensity.
Conclusions:
- Diverse intraperitoneal antibiotics are employed for CAPD peritonitis.
- Ceftazidime/cefazolin combination is a common empirical choice, and vancomycin is frequently used for definitive treatment.
- Further research is needed to assess the clinical outcomes and efficacy of different antibiotic strategies.
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