title: Treatment and outcome of peritonitis in automated peritoneal dialysis, using a once-daily cefazolin-based regimen.
abstract: OBJECTIVE
  We determined the effectiveness of a once-daily cefazolin-based regimen in treating automated peritoneal dialysis (APD) peritonitis.
  
  
  METHODS
  We carried out a retrospective analysis of all APD peritonitis episodes treated with a once-daily cefazolin protocol.
  
  
  METHODS
  The study was performed in a peritoneal dialysis unit in a tertiary care hospital.
  
  
  METHODS
  We studied 60 episodes of primary peritonitis in 40 patients on APD. Each patient was treated with a vancomycin-free regimen consisting of intraperitoneal cefazolin (1.5 g IP) with gentamicin IP administered in the daytime exchange. The main outcome measures were successful treatment of peritonitis, removal of peritoneal catheter, relapse of peritonitis, and patient death.
  
  
  RESULTS
  Gram-positive infections occurred in 35 episodes (58.3%), gram-negative Infections in 10 episodes (16.7%), culture-negative infections in 14 episodes (23.3%), and a yeast infection in 1 episode (1.7%). Of the 60 episodes, 47 (78.3%) were successfully treated. In 10 episodes (16.7%), catheters were removed (9 for treatment failure, 1 for yeast infection). Four patients (8%) had a relapse of infection within 4 weeks of completing antibiotic therapy. One patient (1.7%) died.
  
  
  CONCLUSIONS
  Our results demonstrate that once-daily cefazolin with gentamicin IP is an effective treatment for APD peritonitis, with the advantage of being easy to administer and enabling patients to remain on APD during treatment.
authors.affiliation: Department of Renal Medicine, Imperial College School of Medicine, Charing Cross Hospital, London, UK. RFielding@hhnt.org
authors.forename: Richard E
authors.initials: RE
authors.lastname: Fielding
authors.forename: Michelle
authors.initials: M
authors.lastname: Clemenger
authors.forename: Lawrence
authors.initials: L
authors.lastname: Goldberg
authors.forename: Edwina A
authors.initials: EA
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D002437:Cefazolin / Q000008:administration & dosage* / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002437:Cefazolin