Initial Treatment of Peritoneal Dialysis Peritonitis Without Vancomycin With a Once-Daily Cefazolin-Based Regimen

Goldberg, Lawrence; Clemenger, Michelle; Azadian, B S; Brown, Edwina A.

doi:10.1053/ajkd.2001.20581

Cited by 28 publications

(33 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An initial cure rate of 76.0% is similar to those reported in the literature (21,(23)(24)(25). Higher initial cure rates are reported in patients treated on an outpatient basis (19,20).…”

Section: Discussionsupporting

confidence: 87%

“…In other studies, although not always stated explicitly, most APD patients were switched to CAPD during peritonitis (21,22). Furthermore, adjustments for patient characteristics, such as age and gender, had not been made (23,24) or results were compared with historical data (20,25). Our retrospective study showed several differences in characteristics of our CAPD and APD populations.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Similar Peritonitis Outcome in Capd and APD Patients with Dialysis Modality Continuation during Peritonitis

et al. 2011

View full text Add to dashboard Cite

♦ ♦ ♦ ♦ ♦ Background: As few data exist on treatment of peritonitis in patients on automated peritoneal dialysis (APD), and as pharmacokinetics of several antibiotics are reported to be unfavorable in APD, some favor switching to continuous ambulant PD (CAPD) while treating APD-related peritonitis. We explored whether treating peritonitis with patients continuing their usual PD modality had an effect on outcome.

show abstract

“…An initial cure rate of 76.0% is similar to those reported in the literature (21,(23)(24)(25). Higher initial cure rates are reported in patients treated on an outpatient basis (19,20).…”

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Similar Peritonitis Outcome in Capd and APD Patients with Dialysis Modality Continuation during Peritonitis

et al. 2011

View full text Add to dashboard Cite

show abstract

“…This resolution rate was significantly higher than initial treatment with a first generation cephalosporin plus aminoglycosides (pooled proportion of 66%, 95%CI: 0.57-0.75) from 14 studies [25][26][27][28][29][30][31][32][33][34][35][36][37][38] with a total of 1438 total episodes (Figure 1). Initial treatment with ceftazidime plus a glycopeptide also showed a higher resolution rate than a glycopeptide plus aminoglycosides (pooled proportion of 75%, 95%CI: 0.69-0.80), which was used in 16 studies [29][30][31][38][39][40][41][42][43][44][45][46][47][48][49][50] For treatment of episodes due to gram-positive rods, the pooled resolution rate from 13 [23,39,40,48,49,[51][52][53][54][55][56][57][58] studies with a total of 917 episodes was 78% (95%CI: 0.66-0.88) for a glycopeptide, while the rates from five studies [26,…”

Section: Systematic Reviewsmentioning

confidence: 99%

“…The only third generation cephalosporin we analyzed Comparisons of episodes due to gram-negative rods showed that the pooled proportion resolution rate from nine studies [39,40,49,57,[60][61][62][63] with a total of 138 episodes was 68% (95%CI: 0.50-0.85) for a quinolone. For ceftazidime, the resolution rate was 61% (95%CI: 0.53-0.70) from three studies [33,63,64] with a total of 117 episodes, and for aminoglycosides the resolution rate was 65% (95%CI: 0.51-0.77) from nine studies [23,26,31,39,40,49,55,60,61] with a total of 211…”

Section: Proportional Meta-analysismentioning

confidence: 99%

Evidence-based medicine: An update on treatments for peritoneal dialysis-related peritonitis

Barretti

Doles

Pinotti

et al. 2015

WJN

View full text Add to dashboard Cite

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 metaanalysis 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 gramnegative 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. Core tip: This manuscript revised the data from narrative and systematic review, as well as those from a proportional meta-analysis study, regarding comparisons between antibiotic regimens used to peritoneal dialysis-related treatment, empathizing protocols for initial treatment. There is no consensus on the best treatment and the only published systematic review and its recent update have failed to find superiority of any regimen. This type of analysis, commonly excludes several studies, some of them with a great number of cases. Therefore, this review intends to contribute in this issue analyzing the results from different types of reviews. MINIREVIEWSBarretti P, Doles JVP, Pinotti DG, El Dib RP. Evidence-based medicine: An update on treatments for peritoneal dialysis-related peritonitis. World J Nephrol 2015; 4(2): 287-294 Available from:

show abstract

“…Die ISPD Guidelines 2005 empfehlen eine mindestens sechsstündige intraperitoneale Verweilzeit der Antibiotika, um eine ausreichende Resorption zu ermöglichen [31]. Bei CAPD-Peritonitis zeigen pharmakokinetische [42,43] und klinische Untersuchungen [44][45][46], dass die Einmalgabe der Antibiotika effektiv ist. Bei der einmaligen Verabreichung der Antibiotika in der Tagesverweilzeit der APD-Patienten ist jedoch zu beachten, dass die Clearance dieser Substanzen durch den höheren Dialysatumsatz in der Nacht größer ist als an der CAPD [47].…”

Section: Peritonitis-diagnostik Und Therapie Bei Apd-patientenunclassified

Automated peritoneal dialysis – recent aspects

Vychytil

2005

Wien Klin Wochenschr

View full text Add to dashboard Cite

Automated peritoneal dialysis (APD) is an important treatment option in PD patients with high peritoneal transport rates, in patients with inadequate small-solute clearances during continuous ambulatory peritoneal dialysis (CAPD) treatment, and in patients with complications associated with high intraperitoneal pressure. Because APD offers better flexibility during the daytime, patients often have a better quality of life and are able to go to work or school. However, APD is more expensive and technically more complex than CAPD and there are controversial results on the course of residual renal function and the risk of peritonitis in the two types of treatment. The increased elimination of antibiotic drugs during cycler therapy has to be considered in patients with peritonitis, especially in those using high treatment volumes. When used during the daytime dwell, polyglucose solution has been shown to improve ultrafiltration and reduce the extracellular fluid volume in PD patients. In comparison with conventional dialysis solutions, treatment with pH-neutral solutions allows better correction of metabolic acidosis and is associated with an increase of CA-125 dialysate concentrations and a reduction of infusion pain. Tidal PD has its place in patients with mechanical outflow problems; however, compared with conventional APD, there is no improvement of clearances when the dialysate flow is kept constant. Continuous-flow PD using a double-lumen catheter is more effective but also more expensive than conventional APD. Most studies report a similar or even better patient survival with APD than with CAPD; however, a selection bias cannot be excluded from these mainly retrospective studies. In summary, APD is an established method of PD treatment that provides several advantages to patients and contributes to decreased technical drop-out rates.

show abstract

Initial Treatment of Peritoneal Dialysis Peritonitis Without Vancomycin With a Once-Daily Cefazolin-Based Regimen

Cited by 28 publications

References 11 publications

Similar Peritonitis Outcome in Capd and APD Patients with Dialysis Modality Continuation during Peritonitis

Similar Peritonitis Outcome in Capd and APD Patients with Dialysis Modality Continuation during Peritonitis

Evidence-based medicine: An update on treatments for peritoneal dialysis-related peritonitis

Automated peritoneal dialysis – recent aspects

Contact Info

Product

Resources

About