Fungal Peritonitis in Peritoneal Dialysis Patients: Successful Prophylaxis with Fluconazole, as Demonstrated by Prospective Randomized Control Trial

Abstract

In patients with bacterial peritonitis, administration of prophylactic oral fluconazole throughout the time they received antibiotics significantly prevented the appearance of secondary fungal peritonitis.

Consensus Guidelines for the Prevention and Treatment of Catheter-Related Infections and Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis: 2012 Update

“…Antibiotic use within the preceding 3 months was noted in 94% of the patients who developed a FP preceded by a bacterial peritonitis; such use was seen in only 61% of patients who developed de novo FP (124). A number of studies, only two of which are RCTs, have examined the use of FP prophylaxis with either oral nystatin or fluconazole given during the course of antibiotic therapy (131)(132)(133)(134)(135)(136)(137)(138)(139). The premise for such therapy is the eradication of the normal flora and the overgrowth of yeast in the digestive tract associated with antibiotic therapy.…”

“…The risk associated with the presence of a gastrostomy remains controversial (4). The provision of antifungal prophylaxis during periods of antibiotic use has been advocated in programs characterized by high rates of FP (57,123,126,139) (see guideline 6).…”

Invasive Candidiasis in Patients with Implants

“…Removal of the infected catheter reduces mortality and the risk for repeat fungal peritonitis [45, 48•]. In one study of patients with bacterial peritonitis, administration of prophylactic oral fluconazole throughout the time they received antibiotics significantly reduced patients' chances of later developing fungal peritonitis [50].…”

Evaluation of breviscapine on prevention of experimentally induced abdominal adhesions in rats

“…Peritoneal adhesions are often associated with any kind of abdominal surgery and may lead to significant clinical, economic, and legal consequences. 8 So, it is very important to prevent initial peritoneal adhesions in abdominal surgical operations. The prevention of adhesion formation after abdominal operations is the subject of great interest among surgical doctors.…”