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Antibiotic treatment of infectious peritonitis in chronic peritoneal dialysis
Abstract:
Antibiotic treatment of infectious peritonitis was evaluated in 97 primary episodes registered among 66 patients treated with chronic intermittent peritoneal dialysis over a 3-year period. 87% of the cases could be treated with antibiotics of low toxicity. The chance of continuing peritoneal dialysis after treatment of peritonitis was better among out-patients than among hospitalized patients. The overall continuance rate was 90%. Relapse of the primary infection occurred in 10% of the cases and was associated with a treatment duration shorter than 2 weeks. Superinfection occurred in 5% of the cases. In 15% the dialysis catheters had to be replaced, due primarily to problems of dialysis technique. Death during active peritonitis occurred in 4% of the cases and was associated with severe underlying diseases or complications, such as intestinal perforation and intraperitoneal abscess formation. Side effects attributable to antibiotic treatment occurred in 13% of the cases, the most common side effect being self-limiting diarrhoea.
Insights
Antibiotic therapy effectively treats infectious peritonitis in patients on peritoneal dialysis, with a 90% success rate for continuing dialysis. Shorter treatment durations increased relapse risk.
Area of Science:
- Nephrology
- Infectious Diseases
- Internal Medicine
Background:
- Peritonitis is a significant complication for patients undergoing chronic intermittent peritoneal dialysis.
- Effective antibiotic management is crucial for successful peritonitis treatment and dialysis continuation.
Purpose of the Study:
- To evaluate the efficacy and outcomes of antibiotic treatment for infectious peritonitis in peritoneal dialysis patients.
- To assess factors influencing the continuation of peritoneal dialysis after peritonitis treatment.
Main Methods:
- Retrospective analysis of 97 primary peritonitis episodes in 66 patients on chronic intermittent peritoneal dialysis over 3 years.
- Evaluation of antibiotic toxicity, treatment duration, relapse rates, superinfections, catheter replacement, and mortality.
Main Results:
- 87% of cases treated with low-toxicity antibiotics; 90% overall continuation rate of peritoneal dialysis.
- Relapse occurred in 10% (associated with <2 weeks treatment), superinfection in 5%, catheter replacement in 15%.
- Mortality was 4%, linked to severe underlying conditions or complications.
Conclusions:
- Antibiotic treatment is highly effective for infectious peritonitis in peritoneal dialysis patients, enabling high rates of dialysis continuation.
- Adequate treatment duration (≥2 weeks) appears crucial to prevent relapse.
- While generally safe, antibiotic side effects and technical dialysis issues require monitoring.