Vancomycin and tobramycin in the treatment of CAPD peritonitis.
Seventy-five episodes of continuous ambulatory peritoneal dialysis (CAPD) peritonitis were studied during a 1 year period at the Queen Elizabeth Hospital, Birmingham. When two simple culture methods were used in parallel, the causative organisms were identified in 97% of cases. Nearly two thirds of episodes of peritonitis were caused by coagulase-negative staphylococci (C-NS), many of which were multiply antibiotic-resistant. On the basis of detailed antibiotic sensitivities, intraperitoneal vancomycin and tobramycin were chosen for the initial treatment of CAPD peritonitis. With this regime, a cure was achieved in 32 of 38 episodes, compared with 15 of 27 episodes when cefuroxime was used. All but 1 of 24 episodes caused by C-NS were cured by vancomycin.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000188:drug therapy / Q000209:etiology; D002444:Cefuroxime / Q000627:therapeutic use; D003030:Coagulase / Q000032:analysis; D004352:Drug Resistance, Microbial; D005122:Exudates and Transudates / Q000382:microbiology; D005260:Female; D006090:Gram-Negative Bacteria; D006801:Humans; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D013210:Staphylococcus; D013291:Streptococcus; D014031:Tobramycin / Q000627:therapeutic use*; D014640:Vancomycin / Q000627:therapeutic use*
D003030:Coagulase; D014640:Vancomycin; D002444:Cefuroxime; D014031:Tobramycin