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Title: Once-daily intraperitoneal gentamicin is effective therapy for gram-negative CAPD peritonitis
Authors: Lye, W.-C.
Van Der Straaten, J.C.
Leong, S.-O.
Sivaraman, P.
Tan, S.-H.
Tan, C.-C. 
Lee, E.J.C.
Keywords: Gentamicin
Issue Date: Jul-1999
Citation: Lye, W.-C.,Van Der Straaten, J.C.,Leong, S.-O.,Sivaraman, P.,Tan, S.-H.,Tan, C.-C.,Lee, E.J.C. (1999-07). Once-daily intraperitoneal gentamicin is effective therapy for gram-negative CAPD peritonitis. Peritoneal Dialysis International 19 (4) : 357-360. ScholarBank@NUS Repository.
Abstract: Objective: To report our 3-year experience with the use of once-daily intraperitoneal (IP) gentamicin in the treatment of gram-negative continuous ambulatory peritoneal dialysis (CAPD) peritonitis. Design: A prospective cohort study in prevalent CAPD patients. Setting: A tertiary care institution. Patients: All CAPD patients who presented with new episodes of peritonitis were studied. At presentation with peritonitis, IP vancomycin and gentamicin were administered as empirical therapy. IP gentamicin was given at a single daily dose of 40 mg/2 L in the overnight bag. The antimicrobial agents were reviewed when the culture results became available. Intraperitoneal ceftazidime was added for the treatment of pseudomonas peritonitis. Main Outcome Measures: Results of microbiological cultures and clinical outcomes of peritonitis were analyzed. Results: Over a 36-month period, 190 episodes of peritonitis were recorded, of which 62/190 episodes (32.6%) isolated gram-negative organisms. The gram-negative organisms isolated were Escherichia coli, 15/62 episodes (24.1%); Pseudomonas aeruginosa, 12/62 episodes (19.4%); Acinetobacter spp, 12/62 episodes (19.4%); Klebsiella spp, 10/62 episodes (16.1%); and others, 13/62 episodes (21.0%). The overall treatment success rate was 66.1%. The treatment success rates were 74.0% if pseudomonas infections were excluded, 76.1% if gentamicin-resistant pathogens were excluded, and 80.5% if both pseudomonas infections and gentamicin-resistant pathogens were excluded. Conclusions: Once-daily IP gentamicin appears to be effective in the treatment of gram-negative CAPD peritonitis.
Source Title: Peritoneal Dialysis International
ISSN: 08968608
Appears in Collections:Staff Publications

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