title: Treatment of peritonitis in continuous ambulatory peritoneal dialysis (CAPD) with intraperitoneal cefazolin and gentamicin.
abstract: Between 1983 and 1988 57 peritonitis episodes in an unselected patient population were initially treated with intraperitoneal cefazolin and gentamicin. The loading dose consisted of 500 mg cefazolin/L dialysate and 40 mg gentamicin/L dialysate. The maintenance dosage was 125 mg cefazolin and 8 mg gentamicin per liter dialysate. Forty-five (78.9%) patients were primarily cured with this regimen (responder group = RG). Twelve patients (21.1%) did not respond to the initial therapy (nonresponder group = NG). Eight peritonitis episodes in the NG (14.0% of all patients) were caused by tunnel infections and 2 by diverticulitis (3.5%). The cure rate in patients without tunnel infection or bowel disease was 95.7%. A relapse occurred in 2 patients (3.5%). Duration of therapy was assessed by daily white blood cell count (WBC) in the effluent and treatment was discontinued when the WBC was less than 100/microliters for 3 days. The mean duration of therapy with cefazolin and gentamicin was 8.1 days in the RG and 6.0 days in the NG. Nonresponders were subsequently treated with a modified antibiotic regimen on an average 11.9 days.
authors.affiliation: Robert Bosch Hospital, Teaching Hospital, Eberhard Karls University Tübingen, West Germany.
authors.forename: J
authors.initials: J
authors.lastname: Weber
authors.forename: E
authors.initials: E
authors.lastname: Staerz
authors.forename: T
authors.initials: T
authors.lastname: Mettang
authors.forename: C
authors.initials: C
authors.lastname: Machleidt
authors.forename: U
authors.initials: U
authors.lastname: Kuhlmann
mesh_terms: D002408:Catheters, Indwelling; D002437:Cefazolin / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000209:etiology; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*
chemical_list: D005839:Gentamicins; D002437:Cefazolin