title: Risks and outcomes of peritonitis after flexible colonoscopy in CAPD patients.
abstract: OBJECTIVE
  The ISPD 2005 guidelines for peritonitis recommend antibiotic prophylaxis for patients undergoing colonoscopy with polypectomy while on continuous ambulatory peritoneal dialysis (CAPD) but there is little literature to support this recommendation. This study aimed to look into the risks and outcomes of peritonitis after colonoscopy in CAPD patients.
  
  
  METHODS
  All records of flexible colonoscopy performed on our CAPD patients from January 1994 to January 2006 were retrieved. Demographic and clinical data, use of antibiotics before colonoscopy, endoscopic findings, procedure performed, and peritonitis data were analyzed.
  
  
  RESULTS
  77 CAPD patients underwent 97 colonoscopies. No peritonitis developed in the 18 cases where antibiotics were given before colonoscopy. Among those without antibiotic prophylaxis, 4 episodes of peritonitis occurred within 24 hours after the procedure and 1 occurred 5 days later. All responded to intraperitoneal antibiotics. Colonic biopsy and polypectomy were not associated with more peritonitis (2 in 41 with biopsy vs 3 in 38 without biopsy, p = 0.67; 1 in 30 with polypectomy vs 4 in 49 without polypectomy, p = 0.64).
  
  
  CONCLUSIONS
  The risk of peritonitis after colonoscopy without antibiotic prophylaxis was 6.3%. All peritonitis episodes responded to intraperitoneal antibiotics. Colonic biopsy or polypectomy did not appear to increase the risk of peritonitis. Although statistically not significant when compared with patients without antibiotic prophylaxis, we observed no peritonitis after colonoscopy in patients that were given antibiotics for prophylactic purposes or for other reasons. The efficacy of prophylactic antibiotics would be better defined by large randomized trials.
authors: Department of Medicine, Tung Wah Hospital, University of Hong Kong, Hong Kong SAR, People's Republic of China. terenceyip@netvigator.com
authors: Terence
authors: T
authors: Yip
authors: Kai Chung
authors: KC
authors: Tse
authors: Man Fai
authors: MF
authors: Lam
authors: Suk Wai
authors: SW
authors: Cheng
authors: Sing Leung
authors: SL
authors: Lui
authors: Sydney
authors: S
authors: Tang
authors: Matthew
authors: M
authors: Ng
authors: Tak Mao
authors: TM
authors: Chan
authors: Kar Neng
authors: KN
authors: Lai
authors: Wai Kei
authors: WK
authors: Lo
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003113:Colonoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D010538:Peritonitis / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents