title: Ciprofloxacin in the treatment of gram-positive bacterial peritonitis in patients undergoing CAPD.
abstract: Fluoroquinolones may be a good alternative for the treatment of bacterial peritonitis in patients undergoing continuous ambulatory peritonitis dialysis (CAPD). To test their efficiency against Gram-positive bacteria, we treated with intraperitoneal (i.p.) ciprofloxac in 30 episodes of Gram-positive bacterial peritonitis without manifest tunnel infection of the peritoneal catheters. Treatment was sustained for 5 days, then orally for 10 further days. Clinical and bacteriological responses were satisfactory in 25 cases, but resolution of infection was slow in 5 cases of Staphylococcus aureus. The minimal inhibitory and bactericidal concentrations were 0.0625-0.50 and 0.125-1.0 micrograms/mL respectively, lower than the plasma and dialysate concentrations of the drug. Side effects were negligible. We conclude that ciprofloxacin provides a good therapeutic alternative to more widely used antibiotics for the empirical treatment of peritonitis in patients undergoing CAPD. However, combinations of antibiotics may be necessary, in Staphylococcus aureus peritonitis.
authors.affiliation: Division of Nephrology, Hospital Juan Canalejo, A Coruña, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Pérez-Fontán
authors.forename: M
authors.initials: M
authors.lastname: Rosales
authors.forename: F
authors.initials: F
authors.lastname: Fernández
authors.forename: J
authors.initials: J
authors.lastname: Moncalián
authors.forename: C
authors.initials: C
authors.lastname: Fernández-Rivera
authors.forename: A
authors.initials: A
authors.lastname: Alonso
authors.forename: F
authors.initials: F
authors.lastname: Valdés
mesh_terms: D000284:Administration, Oral; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007274:Injections, Intraperitoneal; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology; D013290:Streptococcal Infections / Q000188:drug therapy / Q000209:etiology
chemical_list: D002939:Ciprofloxacin