Efficacy of Intraperitoneal Clindamycin in Refractory Peritonitis Report of Two Cases

Two patients on CAPD developed peritonitis refractory to antibiotics appropriate to the cultured organisms. In one case, cultures remained positive for the offending bacteria (Staphylococcus aureus) and, in the other, cultures of Enterobacter agglomerans rapidly became negative but signs and symptoms of peritonitis persisted. Empiric clindamycin therapy was associated with rapid resolution of peritonitis in both instances without necessitating catheter removal. We suggest that, in selected cases of refractory peritonitis, the addition of clindamycin may lead to clearing of the infection with preservation of the peritoneal catheter.