For permission to reprint multiple copies or to order presentation-ready copies for distribution, contact Multimed Inc. at publishing_services@multi-med.comPeritoneal Dialysis (ISPD) guidelines (7) eliminated the tfor APD antibiotics and only showed dosing for CAPD as opposed to the guidelines in 2010 (13–15). We urge further research on these areas to enhance treatment of peritonitis and improve outcomes. Development 19.

in designing and carrying out these studies. levels stay at 15 μg/mL as a minimum. In general, patients with minimal pain could be treated on an outpatient basis with intraperitoneal (IP) antibiotic therapy if this can be arranged. Once the catheter is placed, and until healing is com-pleted, the dressing changes should be done by a dialy-sis nurse using sterile technique. Intraperitoneal vconcentrations during per itoneal dialysis-associated peritonitis: correlaMJ. Many of the studies evaluating treatment of PD-related peritonitis are small, out-dated, of poor quality, and had inconsistent definitions and dosing regimens.

This is a very convenient However, the once-daily antibiotic dosing recommendations are based primarily on studies with continuous ambulatory PD (CAPD) regimens.

As simple contaminations decrease, other causes of infection assume greater importance in the remaining episodes.Clinicians treating peritoneal dialysis (PD)-associated peritonitis should be aware that continuous ambulatory PD (CAPD) and automated PD (APD) have different effects on the pharmacokinetics of antibiotics. However, of vancomycin at the end of the rapid cycles and daily dosing may be preferable (25). 0.9mg/L during relapse-free episodes A recent paper looked retrospectively at a group of 35 Canadian patients with 58 episodes of coagulase-negative Third generation antibiotics are almost always given in the long dwell daily. Peritonitis is a common complication of peritoneal dialysis (PD) that is associated with substantial morbidity and mortality. 42. van der Hulst RJ, Boeschoten EW, Nielsen FW, STange RA. We explored whether treating peritonitis with patients continuing their usual PD modality had an effect on outcome. Because of the PAE, aminoglycosides are suited Intermittent dosing of aminoglycosides may be more toxicity may become an issue. Is it less toxic than multiple daily doses and how should it be monitored?Gentamicin administration via peritoneal dialysis fluid: the risk of ototoxicityOtotoxicity monitoring with ultra-high frequency audiometry in peritoneal dialysis patients treated with vancomycin or gentamicinIs intraperitoneal tobramycin ototoxic in CAPD patients?Gentamicin ototoxicity in continuous ambulatory peritoneal dialysisThe role of monitoring gentamicin levels in patients with gram-negative peritoneal dialysis-associated peritonitisComparative study of the pharmacokinetics of various β-lactams after intravenous and intraperitoneal administration in patients Also, after correction for possible confounders, odds ratios for death and for the combined end point death or catheter removal showed no difference when patients treated for peritonitis stayed on their own modality. Longer duration treatment (21 days of IV vancomycin and IP gentamicin) had uncertain effects on risk of treatment relapse compared with 10 days treatment (1 study, 49 patients: RR 1.56, 95% CI 0.60 to 3.95) although may have increased ototoxicity.In general, review conclusions were based on a small number of studies with few events in which risk of bias was generally high; interventions were heterogeneous, and outcome definitions were often inconsistent. Although there is much focus on preventing PD-associated peritonitis, equally as important is appropriate management to minimize the morbidity of a peritonitis episode once it has occurred. this is the form of dialysis that most patients utilize in the western world. Dialysis Study Group (MEPPS). However(21). Published data from the late 1970s demonstrated very high peritonitis rates, using primitive connectology.

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