title: The efficacy of exit site povidone-iodine ointment in the prevention of early peritoneal dialysis-related infections.
abstract: Infections are the main complications of peritoneal dialysis, and currently there is no established method for prevention. A prospective, randomized, single-blind study was performed to evaluate the efficacy of regular application of povidone-iodine ointment at the catheter site (during the entire time on the study) in peritoneal dialysis. One hundred twenty patients were randomized; three were excluded for not completing the study. Sixty-one patients received application of povidone-iodine and 56 patients received standard care. Povidone-iodine ointment was effective in delaying infectious complications, with a lower proportion of treated patients having infections (exit site and peritonitis) within 140 days of starting dialysis compared with the controls (P = 0.04, Wilcoxon test). This protective benefit was lost after 140 days on dialysis. Staphylococcus aureus infections developed in only two (3.3%) of the treated patients compared with 10 (21.4%) of the controls (P = 0.009), despite the higher rate of S aureus nasal carriage in the treated group (22 of 61 patients [36%] v 14 of 56 patients [25%]).
authors.affiliation: Department of Pharmacy, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: N M
authors.initials: NM
authors.lastname: Waite
authors.forename: N
authors.initials: N
authors.lastname: Webster
authors.forename: M
authors.initials: M
authors.lastname: Laurel
authors.forename: M
authors.initials: M
authors.lastname: Johnson
authors.forename: I W
authors.initials: IW
authors.lastname: Fong
mesh_terms: D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000295:instrumentation; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011446:Prospective Studies; D016037:Single-Blind Method
chemical_list: D000891:Anti-Infective Agents, Local; D009824:Ointments; D011206:Povidone-Iodine