Iatrogenic Peritonitis: The Need for Prophylaxis

Whether to use or Not Prophylactic Antibiotics in Automated Peritoneal Dialysis Patients Undergoing Colonoscopy, A Prospective Controlled Randomized Study

“…These reports suggested that instrumental procedures such as colonoscopy may precipitate gram-negative peritonitis in PD patients. On the other hand, some literature reported bacterial peritonitis following endoscopic polypectomy in peritoneal dialysis patients despite antibiotics prophylaxis (10). So far there are no strong data demonstrating a causal association between endoscopic procedures and bacteremia or that antibiotic prophylaxis prior to endoscopic procedures protects against bacteremia.…”

“…It has been suggested that antibiotic prophylaxis be given to immunocompromised patients and those with known valvular heart disease or prostheses prior to colonoscopy (4,5). Few cases have been reported in the literature on peritonitis following colonoscopy in CAPD patients (6)(7)(8)(9)(10). These reports suggested that diagnostic instrumental procedures such as colonoscopy may precipitate gram-negative peritonitis in CAPD patients.…”

The evidence base for the efficacy of antibiotic prophylaxis in dental practice

“…143,144 However, PD catheters are considered to be at much lower risk of infection associated with invasive dental procedures than are hemodialysis shunts. [145][146][147] Most publications concerning antibiotic prophylaxis either do not mention PD catheters or a risk resulting from dental procedures or they recommend against prophylaxis. 14 However, some authors recommend prophylaxis for these patients on the basis of a few case reports of peritonitis, in spite of the fact that the bacteria cultured from these infections have little or no specificity for the oral cavity in the vast majority of cases (such as S. aureus and S. epidermidis, pseudomonas and other gastrointestinal [GI] species) and that the dental condition and/or procedure was not well-documented.…”

“…14 However, some authors recommend prophylaxis for these patients on the basis of a few case reports of peritonitis, in spite of the fact that the bacteria cultured from these infections have little or no specificity for the oral cavity in the vast majority of cases (such as S. aureus and S. epidermidis, pseudomonas and other gastrointestinal [GI] species) and that the dental condition and/or procedure was not well-documented. 134,[145][146][147][148][149] Guidelines for PD were first published in 1983 and were updated in 2005 with a stronger emphasis on prevention of infection. 144 These guidelines suggest that "invasive procedures may infrequently cause peritonitis in PD patients," and suggest that "a single dose of amoxicillin (2 g) 2 hours before extensive dental procedures," but point out that "there are no studies to support this approach."…”

Evaluating the Risk of Peritonitis Post Colonoscopy in End Stage Renal Disease Patients on Peritoneal Dialysis: A Prospective Randomized Trial of Intraperitoneal Prophylactic Antibiotic at a Single Center

“…Colorectal cancer is still the fourth leading cause of cancer related death in the world [1]. Although controversial, the overall incidence of cancer is reported to be higher in patients with ESRD than in the general population [2][3][4][5][6][7][8]. Unfortunately, no studies have documented the rate of colorectal cancer among patients with end stage renal disease [5].…”