Shemin DG, Maaz D
Gram-negative peritonitis: improved outcome with IP
ceftazidime
XVIth Annual CAPD Conference
Perit Dial Int Suppl 2
(Feb) 16:S44 1996
This is a small observational study comparing treatment results of gram
negative peritonitis with
two different antibiotic regimens. Nine patients treated before 1993
received an IP aminoglycoside
plus another appropriate "systemic" antibiotic. After 1993, 8 patients
received a 14 day course of
IP ceftazidime plus oral or IV ciprofloxacin. Peritonitis resolved without
catheter removal in 75%
of the ceftazidime group versus only 22% of the aminoglycoside group. The
authors use their data to
conclude that aminoglycosides can be substituted by other, less toxic drugs
to treat gram negative
peritonitis.
Comment: My concern is with the extraordinarily low success rate of
cure of peritonitis with
aminoglycosides. Not enough details are available, but this observation is
contrary to other
published reports. I do not doubt the efficiency of the ceftazidime
treatment (at what cost?), but
would not, given the overall evidence available, discard the use of
aminoglycosides for gram
negative peritonitis.
(Stephen I. Vas, M.D.)
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XVIth Annual CAPD Conference
Basic peritoneal dialysis :
Peritonitis and exit-site infection