title: Efficacy of Prophylactic Antibiotics at Peritoneal Catheter Insertion on Early Peritonitis: Data from the Catheter Section of the French Language Peritoneal Dialysis Registry.
abstract: International guidelines recommend the use of a prophylactic antibiotic before the peritoneal dialysis (PD) catheter can be inserted. The main objective of this study was to assess whether this practice is associated with a lower risk of early peritonitis and to estimate the magnitude of the centre effect.
  
  
  
  A retrospective, multi-centric study was conducted, in which data from the French Language Peritoneal Dialysis Registry was analysed. Patients were separated into 2 groups based on whether or not prophylactic antibiotics were used prior to catheter placement.
  
  
  
  Out of the 2,014 patients who had a PD catheter placed between February 1, 2012 and December 31, 2014, 1,105 were given a prophylactic antibiotic. In a classical logit model, the use of prophylactic antibiotics was found to protect the individual against the risk of early peritonitis (OR 0.67, 95% CI 0.49-0.92). However, this association lost significance in a mixed logistic regression model with centre as a random effect: OR 0.73 (95% CI 0.48-1.09). Covariates associated with the risk of developing early peritonitis were age over 65: OR 0.73 (95% CI 0.39-0.85), body mass index over 35 kg/m2: OR 1.99 (95% CI 1.13-3.47), transfer to PD due to graft failure: OR 2.24 (95% CI 1.22-4.11), assisted PD: OR 1.96 (95% CI 1.31-2.93), and the use of the Moncrief technique: OR 3.07 (95% CI 1.85-5.11).
  
  
  
  There is a beneficial effect of prophylactic antibiotic used prior to peritoneal catheter placement, on the occurence of early peritonitis. However, the beneficial effect could be masked by a centre effect.
authors: Department of Néphrologie, CUMR, CHU de Caen, Caen Cedex, France.
authors: Antoine
authors: A
authors: Lanot
authors: Thierry
authors: T
authors: Lobbedez
authors: Clémence
authors: C
authors: Bechade
authors: Christian
authors: C
authors: Verger
authors: Emmanuel
authors: E
authors: Fabre
authors: Max
authors: M
authors: Dratwa
authors: Isabelle
authors: I
authors: Vernier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D057785:Catheters / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000295:instrumentation*; D010538:Peritonitis / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies