[Peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. Evaluation of cephalothin/cephalexin...

To evaluate the initial antibiotic regime of cephalothin monotherapy in the treatment of peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD), the frequency of peritonitis was registered retrospectively together with the frequency of recurrent episodes and change of antibiotic. A median frequency of 0.96 episodes per year of dialysis was found. In 24% of the episodes no microorganism was cultured. 82% of the microorganisms were gram-positive cocci, 17% gram-negative rods. The frequency of recurrent episodes was 7%. The initial antibiotic treatment with cephalothin had to be changed in 33% of the cases due to microbial resistance. In another 33% the antibiotic treatment was changed to something with a narrower spectrum. More than one third of the resistant microorganisms were methicillin-resistant coagulase-negative staphylococci. With quick and reliable microbiological diagnostic technique that makes it possible to change the antibiotic treatment early, we find cephalothin to be a suitable initial monotherapy.