Role of catheter removal in therapy of bacterial peritonitis of continuous ambulatory peritoneal dialysis.
Bacterial peritonitis in Continuous Ambulatory Peritoneal Dialysis (CAPD) patients usually responds within a few days to intraperitoneal antibiotics. Catheter removal is rarely needed to resolve the episodes unless they are complicated by endogenous sources such as perforated diverticulitis or infections of the extraperitoneal catheter section. Recurrent peritonitis with the same organism has been attributed to bacterial colonization of the intraperitoneal section, making the decision for catheter removal more difficult. Catheter removal with substitution of hemodialysis may have greater morbidity than prolonged antibiotics. The authors retrospectively analyzed our incidence of and reasons for catheter removal during therapy for bacterial peritonitis for the period from October 1, 1980, to December 31, 1986. For uncomplicated peritonitis, that is, in the absence of infection of the extraperitoneal catheter section, endogenous sources, and episodes associated with catheter function problems per se, the authors were able to resolve the peritonitis without catheter removal in 99.2% of cases. It was concluded that the intraperitoneal catheter section plays a negligible role in thwarting therapeutic efforts in uncomplicated bacterial peritonitis of CAPD.
Zappacosta
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AR
Bryn Mawr Hospital Dialysis Unit, PA 19010.
Perras
S T
ST
D001424:Bacterial Infections / Q000628:therapy*; D002408:Catheters, Indwelling; D003428:Cross Infection / Q000628:therapy; D006801:Humans; D007274:Injections, Intraperitoneal; D016030:Kidney Transplantation; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010538:Peritonitis / Q000628:therapy*; D014031:Tobramycin / Q000008:administration & dosage / Q000627:therapeutic use; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use
D014640:Vancomycin; D014031:Tobramycin