[Treating peritonitis in peritoneal dialysis: guideline from the Italian Society of Nephrology].
BACKGROUND
The current 3rd edition of the Italian Society of Nephrology guidelines has been drawn up to summarize evidence of key intervention issues on the basis of systematic reviews (SR) of randomized trials (RCT) or RCT data only. The present guideline reports evidence of interventions to treat peritonitis in peritoneal dialysis (PD).


METHODS
SR of RCT and RCT on treatments for peritoneal dialysis peritonitis were identified referring to a Cochrane Library and Renal Health Library search (2005 update). Quality of SR and RCT was assessed according to current methodological standards.


RESULTS
Thirty-six RCT were found addressing the intervention issue. Vancomycin or first generation cephalosporins may be used for treating peritoneal dialysis peritonitis due to Gram-positive agents. Third-generation cephalosporins or amino-glycosides may be used for Gram-negative agents peritonitis. Association of first-generation cephalosporins and agents against Gram-negative bacteria via the intraperitoneal route represents the most frequently used approach. Intraperitoneal administration of antibiotic agents is the most effective treatment of peritoneal dialysis peritonitis. Intermittent administration may be preferred to continuous administration of antibiotic agents in peritoneal dialysis peritonitis.


CONCLUSIONS
In peritoneal dialysis peritonitis current evidence supports the hypothesis that intraperitoneal administration of antibiotics agents and intermittent administration may be preferred to other routes of administration and continuous administration. Further studies are necessary to test this hypothesis in selected patient populations.
La Milia
V
V
Italian Society of Nephrology - Italy.
Virga
G
G
D'Amico
M
M
Russo
R
R
Corciulo
R
R
Amici
A
A
De Vecchi
A
A
Feriani
M
M
Salomone
M
M
Cancarini
G
G
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D006801:Humans; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents