title: Infection Prophylaxis in Peritoneal Dialysis Patients: Results from an Australia/New Zealand Survey.
abstract: ♦ BACKGROUND: Clinical practice guidelines aim to reduce the rates of peritoneal dialysis (PD)-related infections, a common complication of PD in end-stage kidney disease patients. We describe the clinical practices used by Australian and New Zealand nephrologists to prevent PD-related infections in PD patients. ♦ METHODS: A survey of PD practices in relation to the use of antibiotic and antifungal prophylaxis in PD patients was conducted of practicing nephrologists identified via the Australia and New Zealand Society of Nephrology (ANZSN) membership in 2013. ♦ RESULTS: Of 333 nephrologists approached, 133 (39.9%) participated. Overall, 127 (95.5%) nephrologists prescribed antibiotics at the time of Tenckhoff catheter insertion, 85 (63.9%) routinely screened for nasalS. aureuscarriage, with 76 (88.4%) reporting they treatedS. aureuscarriers with mupirocin ointment. Following Tenckhoff catheter insertion, 79 (59.4%) prescribed mupirocin ointment at the exit site or intranasally, and 93 (69.9%) nephrologists routinely prescribed a course of oral antifungal agent whenever their PD patients were given a course of antibiotics. ♦ CONCLUSIONS: Although the majority of nephrologists prescribe antibiotics at the time of Tenckhoff catheter insertion, less than 70% routinely prescribe mupirocin ointment and/or prophylactic antifungal therapy. This variation in practice in Australia and New Zealand may contribute to the disparity in PD-related infection rates that is seen between units.
authors.affiliation: Centre for Kidney Research, Sydney Children's Hospital Network (Westmead), Westmead, NSW, Australia denise.campbell@health.nsw.gov.au.|School of Public Health, University of Sydney, Sydney, NSW, Australia.
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Campbell
authors.affiliation: University of Queensland at Princess Alexandra Hospital, Brisbane, QLD, Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Mudge
authors.affiliation: University of Sydney and George Institute for Global Health, Sydney, NSW, Australia.
authors.forename: Martin P
authors.initials: MP
authors.lastname: Gallagher
authors.affiliation: Sir Charles Gairdner Hospital, Perth, WA, Australia.
authors.forename: Wai Hon
authors.initials: WH
authors.lastname: Lim
authors.affiliation: Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
authors.forename: Dwaraka
authors.initials: D
authors.lastname: Ranganathan
authors.affiliation: Whangarei Hospital, Northland District Health Board, Whangarei, New Zealand.|University of Auckland, Auckland, New Zealand.
authors.forename: Walaa
authors.initials: W
authors.lastname: Saweirs
authors.affiliation: Centre for Kidney Research, Sydney Children's Hospital Network (Westmead), Westmead, NSW, Australia.|School of Public Health, University of Sydney, Sydney, NSW, Australia.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D001315:Australia; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D000072104:Nephrologists / Q000706:statistics & numerical data; D009520:New Zealand; D017063:Outcome Assessment, Health Care; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D010818:Practice Patterns, Physicians'; D011322:Primary Prevention / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic prophylaxis; antifungal agents; chronic; kidney failure; peritoneal dialysis; practice guideline