Intraperitoneal Vancomycin/Oral Pefloxacin versus Intraperitoneal Vancomycin/Gentamicin in the Treatment of Continuous Ambulatory Peritoneal Dialysis Peritonitis

Sixty patients were enrolled In a prospective, randomized study to evaluate the efficacy of two different regl mens for the empirical treatment of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. At presentation, Group I received Intraperitoneal vancomycin (1 g) and oral pefioxacin (400 mg b.l.d.), and Group II Intraperitoneal vancomycin (1 g) and gentamicin (80 mg loading dose, followed by 15 mg/2 L). Treatment duration was 14 days. Despite randomization, Group I had significantly more patients with primary Candida peritonitis. When fungal peritonitis was excluded from analysis, there were no significant differences In the treatment success rate (Group I, 73.3% vs Group II, 80.0%, p=NS), number of relapses (Group 1,0 vs Group II, 1), and Tenckhoff catheter removal rates (Group 1,26.6% vs Group 11,16.6%, p=NS) between the two groups. The patients treated with pefioxacin had an increased incidence of nausea and vomiting. In selected situations oral pefioxacin may be a suitable substitute for intraperitoneal gentamicin as outpatient therapy for CAPD peritonitis.