title: Efficacy and safety of meropenem plus tobramycin followed by meropenem plus vancomycin for treating peritonitis in patients on continuous ambulatory peritoneal dialysis.
abstract: Peritonitis is a serious complication in patients on peritoneal dialysis. We examined the efficacy of MTV therapy [first 7 days: meropenem 0.5 g intravenously (IV) twice daily, plus tobramycin 15 mg intraperitoneally (IP) in every dialysis bag; next 7 days: meropenem 0.5 g IV twice daily, plus vancomycin 8 mg/kg IP in every bag after a 1-g loading dose] on peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD), comparing it with the treatment previously recommended by the International Society for Peritoneal Dialysis (combination of first-generation cephalosporins and aminoglycosides). We treated 36 CAPD peritonitis episodes with MTV therapy. Outcome measures were primary response rate at day 14 and relapse rate within 28 days after the start of antibiotic therapy. The primary response rate was 34/36 (94.4%). No patients treated with MTV therapy required catheter removal. We observed no serious side effects in these patients. We conclude that MTV therapy may be an even better choice of treatment for peritonitis in patients on CAPD than was the previous empirical treatment (combination of first-generation cephalosporin and aminoglycosides).
authors.affiliation: Department ofNephrology, Saitama Medical School, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Hidetomo
authors.initials: H
authors.lastname: Nakamoto
authors.forename: Saiko
authors.initials: S
authors.lastname: Okada
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hoshitani
authors.forename: Kosuke
authors.initials: K
authors.lastname: Uchida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Arima
authors.forename: Junko
authors.initials: J
authors.lastname: Shoda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Takane
authors.forename: Naofumi
authors.initials: N
authors.lastname: Ikeda
authors.forename: Soichi
authors.initials: S
authors.lastname: Sugahara
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Okada
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D013845:Thienamycins / Q000008:administration & dosage*; D014031:Tobramycin / Q000008:administration & dosage*; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D014640:Vancomycin; D000077731:Meropenem; D014031:Tobramycin