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Efficacy of a non‐vancomycin‐based peritoneal dialysis peritonitis protocol
Author(s) -
TOUSSAINT NIGEL,
MULLINS KIM,
SNIDER JONATHON,
MURPHY BRENDAN,
LANGHAM ROBYN,
GOCK HILTON
Publication year - 2005
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2005.00379.x
Subject(s) - medicine , peritonitis , peritoneal dialysis , vancomycin , gentamicin , antibiotics , antimicrobial , population , intensive care medicine , staphylococcus aureus , microbiology and biotechnology , environmental health , biology , bacteria , genetics
SUMMARY: Background: Peritonitis has a significant impact upon morbidity and mortality of peritoneal dialysis (PD) patients. Gram‐positive organisms account for the majority of infections and vancomycin is a cost effective broad‐spectrum antimicrobial treatment for PD peritonitis, but this may lead to the emergence of multiple antibiotic‐resistant organisms. The purpose of the present paper was to evaluate the efficacy of a non‐vancomycin‐based protocol comprising cephazolin and gentamicin, which was introduced in the present PD population as empirical treatment for peritonitis. Methods: The study involved 82 peritonitis episodes over a 4‐year period in 58 patients, excluding those with previous methicillin‐resistant staphylococcal peritonitis. Results: With cephazolin and gentamicin there was no apparent difference in response or relapse rates in comparison to reported studies using vancomycin‐based first‐line therapy protocols. Conclusion: We advocate initial treatment of PD peritonitis with non‐vancomycin‐based therapy given similar efficacy and the potential for reduction of resistant organisms.