Abstract

Background

Relapsing and recurrent peritonitis episodes are major causes of technique failure in peritoneal dialysis (PD). We examined the efficacy of extended antibiotic therapy for the prevention of relapsing and recurrent peritonitis.

Methods

From February 2016 to November 2018 we recruited 254 PD patients who fulfilled the diagnostic criteria for PD peritonitis. They were randomized to a standard group, with the duration of intraperitoneal (IP) antibiotic treatment following the International Society for Peritoneal Dialysis (ISPD) guideline according to the causative microorganisms, and an extended group, with 1 extra week of IP antibiotics. The primary endpoint was relapsing, recurrent or repeat peritonitis episodes within 6 months.

Results

The primary endpoint developed in 36 and 29 patients of the extended and standard groups, respectively (28.3% versus 22.8%; P = 0.34). The rate of complete cure, without relapsing, recurrent or repeat peritonitis within 6 months, was 63.8 and 69.3% for the extended and standard groups, respectively (P = 0.35). Repeat peritonitis episodes were more common in the extended than the standard group (15.0% versus 5.5%; P = 0.013).

Conclusions

In patients with PD-related peritonitis, extending the antibiotic therapy for 1 extra week beyond the ISPD protocol should not be recommended. Extending the treatment does not reduce the risk of relapsing or recurrent peritonitis episodes but rather is associated with a higher risk of repeat peritonitis episodes.

Details

Title
Extended antibiotic therapy for the prevention of relapsing and recurrent peritonitis in peritoneal dialysis patients: a randomized controlled trial
Author
Cheuk-Chun Szeto 1 ; Jack Kit-Chung Ng 2 ; Fung, Winston Wing-Shing 2 ; Chan, Gordon Chun-Kau 2 ; Cheng, Phyllis Mei-Shan 1 ; Ka-Bik Lai 1 ; Wing-Fai Pang 2 ; Chow, Kai-Ming 2 ; Chi-Bon Leung 2 ; Philip Kam-Tao Li 2 

 Department of Medicine, Carol & Richard Yu Peritoneal Dialysis Research Centre, Prince of Wales Hospital, Shatin, China; Department of Therapeutics, Carol & Richard Yu Peritoneal Dialysis Research Centre, Prince of Wales Hospital, Shatin, China; Faculty of Medicine, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Shatin, China 
 Department of Medicine, Carol & Richard Yu Peritoneal Dialysis Research Centre, Prince of Wales Hospital, Shatin, China; Department of Therapeutics, Carol & Richard Yu Peritoneal Dialysis Research Centre, Prince of Wales Hospital, Shatin, China 
Pages
991-997
Publication year
2021
Publication date
Mar 2021
Publisher
Oxford University Press
ISSN
20488505
e-ISSN
20488513
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3169589277
Copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.