Evidence-based Medicine: An Update on Treatments for Peritoneal Dialysis-related Peritonitis

Overview

Journal World J Nephrol

Publisher Baishideng Publishing Group

Specialty Nephrology

Date 2015 May 8

PMID 25949943

Citations 6

Authors

Pasqual Barretti

Joao Vitor Pereira Doles

Douglas Goncalves Pinotti

Regina Paolucci El Dib

Affiliations

Soon will be listed here.

Abstract

Peritonitis continues to be a major complication of peritoneal dialysis (PD), and adequate treatment is crucial for a favorable outcome. There is no consensus regarding the optimal therapeutic regimen, and few prospective controlled studies have been published. The objective of this manuscript is to review the results of PD peritonitis treatment reported in narrative reviews, systematic reviews, and proportional meta-analyses. Two narrative reviews, the only existing systematic review and its update published between 1991 and 2014 were included. In addition, we reported the results of a proportional meta-analysis published by our group. Results from systematic reviews of randomized control trials (RCT) and quasi-RCT were not able to identify any optimal antimicrobial treatment, but glycopeptide regimens were more likely to achieve a complete cure than a first generation cephalosporin. Compared to urokinase, simultaneous catheter removal and replacement resulted in better outcomes. Continuous and intermittent IP antibiotic use had similar outcomes. Intraperitoneal antibiotics were superior to intravenous antibiotics in reducing treatment failure. In the proportional meta-analysis of RCTs and the case series, the resolution rate (86%) of ceftazidime plus glycopeptide as initial treatment was significantly higher than first generation cephalosporin plus aminoglycosides (66%) and glycopeptides plus aminoglycosides (75%). Other comparisons of regimens used for either initial treatment or treatment of gram-positive rods or gram-negative rods did not show statistically significant differences. The superiority of a combination of a glycopeptide and a third generation cephalosporin was also reported by a narrative review study published in 1991, which reported an 88% resolution rate.

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References

Guest S, Erickson L . Combination therapy involving ciprofloxacin for peritonitis. Perit Dial Int. 1996; 16(3):316-8. View

Were A, Marsden A, Tooth A, Ramsden R, Mistry C, Gokal R . Netilmycin and vancomycin in the treatment of peritonitis in CAPD patients. Clin Nephrol. 1992; 37(4):209-13. View

Friedland J, Iveson T, Fraise A, Winearls C, Selkon J, Oliver D . A comparison between intraperitoneal ciprofloxacin and intraperitoneal vancomycin and gentamicin in the treatment of peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD). J Antimicrob Chemother. 1990; 26 Suppl F:77-81. DOI: 10.1093/jac/26.suppl_f.77. View

Chen K, Chang C, Weng S, Yu C, Fang J, Huang J . Culture-negative peritonitis: a fifteen-year review. Ren Fail. 2007; 29(2):177-81. DOI: 10.1080/08860220601098847. View

Lye W, Lee E, van der Straaten J . Intraperitoneal vancomycin/oral pefloxacin versus intraperitoneal vancomycin/gentamicin in the treatment of continuous ambulatory peritoneal dialysis peritonitis. Perit Dial Int. 1993; 13 Suppl 2:S348-50. View

Quintanar Lartundo J, Palomar R, Dominguez-Diez A, Salas C, Ruiz-Criado J, Rodrigo E . Microbiological profile of peritoneal dialysis peritonitis and predictors of hospitalization. Adv Perit Dial. 2011; 27:38-42. View

Bennett-Jones D, Russell G, Barrett A . A comparison between oral ciprofloxacin and intra-peritoneal vancomycin and gentamicin in the treatment of CAPD peritonitis. J Antimicrob Chemother. 1990; 26 Suppl F:73-6. DOI: 10.1093/jac/26.suppl_f.73. View

Lai M, Kao M, Chen C, Cheung S, Chung W . Intraperitoneal once-daily dose of cefazolin and gentamicin for treating CAPD peritonitis. Perit Dial Int. 1997; 17(1):87-9. View

Blunden M, Zeitlin D, Ashman N, Fan S . Single UK centre experience on the treatment of PD peritonitis--antibiotic levels and outcomes. Nephrol Dial Transplant. 2007; 22(6):1714-9. DOI: 10.1093/ndt/gfm079. View

10.

Goldberg L, Clemenger M, Azadian B, Brown E . Initial treatment of peritoneal dialysis peritonitis without vancomycin with a once-daily cefazolin-based regimen. Am J Kidney Dis. 2001; 37(1):49-55. DOI: 10.1053/ajkd.2001.20581. View

11.

Weber J, Kuhlmann U . Intraperitoneal cefazolin and gentamicin in the management of CAPD-related peritonitis. Contrib Nephrol. 1991; 89:108-18. DOI: 10.1159/000419757. View

12.

Gucek A, Bren A, Hergouth V, Lindic J . Cefazolin and netilmycin versus vancomycin and ceftazidime in the treatment of CAPD peritonitis. Adv Perit Dial. 1997; 13:218-20. View

13.

Barretti P, Montelli A, Batalha J, Caramori J, Cunha M . The role of virulence factors in the outcome of staphylococcal peritonitis in CAPD patients. BMC Infect Dis. 2009; 9:212. PMC: 2807432. DOI: 10.1186/1471-2334-9-212. View

14.

. Continuous ambulatory peritoneal dialysis (CAPD) peritonitis treatment recommendations: 1989 update. The Ad Hoc Advisory Committee on Peritonitis Management. Perit Dial Int. 1989; 9(4):247-56. View

15.

Silva M, Pecoits-Filho R, Rocha C, Stinghen A, Pachaly M, Nascimento M . The recommendations from the International Society for Peritoneal Dialysis for Peritonitis Treatment: a single-center historical comparison. Adv Perit Dial. 2004; 20:74-7. View

16.

Keane W, Bailie G, Boeschoten E, Gokal R, Golper T, Holmes C . Adult peritoneal dialysis-related peritonitis treatment recommendations: 2000 update. Perit Dial Int. 2000; 20(4):396-411. View

17.

Percival A, Cohen S . The treatment of peritoneal infections in patients on peritoneal dialysis. Postgrad Med J. 1967; 43:Suppl 43:160-5. View

18.

Wong K, Chan Y, Cheung C, Chak W, Choi K, Leung S . Cefepime versus vancomycin plus netilmicin therapy for continuous ambulatory peritoneal dialysis-associated peritonitis. Am J Kidney Dis. 2001; 38(1):127-31. DOI: 10.1053/ajkd.2001.25205. View

19.

Huang S, Chuang Y, Cheng C, Wu M, Chen C, Yu T . Evolution of microbiological trends and treatment outcomes in peritoneal dialysis-related peritonitis. Clin Nephrol. 2011; 75(5):416-25. DOI: 10.5414/cnp75416. View

20.

Szeto C, Kwan B, Chow K, Lau M, Law M, Chung K . Coagulase negative staphylococcal peritonitis in peritoneal dialysis patients: review of 232 consecutive cases. Clin J Am Soc Nephrol. 2007; 3(1):91-7. PMC: 2390994. DOI: 10.2215/CJN.03070707. View