title: Prevention of peritonitis in newly-placed peritoneal dialysis catheters: efficacy of oral prophylaxis with cefuroxime axetil - a preliminary study.
abstract: BACKGROUND
  Peritonitis is one of the causes of early peritoneal dialysis (PD) failure in newly-placed catheters. Antibiotic prophylaxis has been recommended to decrease the risk of infection after PD catheter placement. In this study, we compared the efficacy of parenteral versus oral prophylactic cefuroxime axetil for preventing peritonitis after placed PD catheters.
  
  
  METHODS
  In total, 67 patients (F/M: 32/35; mean age: 46.6±13.2 years) undergoing 70 percutaneous PD catheter placement procedures were included (in three patients, placement was repeated). In 37 patients (parenteral group), we administered a single intravenous (IV) 750-mg dose of cefuroxime axetil, approximately 30 min before placement. In the oral group, 33 patients received a 500-mg dose of oral cefuroxime axetil 1 hour before the procedure and the patients continued that twice daily for 3 days. Patients were evaluated for peritonitis over the following 14 days. The costs of both oral and parenteral forms of cefuroxime axetil were calculated.
  
  
  RESULTS
  The two groups were similar regarding age and gender. Three patients (9%) in the oral group and three (8.1%) in the parenteral group developed peritonitis (P=0.578). All were responded to therapy for peritonitis. The cost of parenteral prophylaxis was $US 7.58, while that of the oral form was $US 3.92.
  
  
  CONCLUSIONS
  For patients undergoing percutaneous PD catheter insertion, a 3-day regimen of oral cefuroxime axetil for preventing early peritonitis was safe, equally effective, and had lower cost comparing with single intravenous dose of the same agent.
authors: Division of Nephrology, Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey - arzuvelioglu@gmail.com.
authors: Arzu
authors: A
authors: Velioglu
authors: Ebru
authors: E
authors: Asicioglu
authors: Elif
authors: E
authors: Ari
authors: Hakki
authors: H
authors: Arikan
authors: Serhan
authors: S
authors: Tuglular
authors: Cetin
authors: C
authors: Ozener
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000191:economics / Q000379:methods; D002408:Catheters, Indwelling / Q000009:adverse effects; D002444:Cefuroxime / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000379:methods; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000191:economics / Q000295:instrumentation*; D010538:Peritonitis / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D000900:Anti-Bacterial Agents; D002444:Cefuroxime; C040738:cefuroxime axetil