Guest SS, Berenji MS, Erickson LJ
Management of Pseudomonal exit-site infection
17th Annual CAPD Conference
Perit Dial Int Suppl 1
(Feb) 17:S60 1997
In this small study (9 episodes) of Pseudomonas exit site
infection (ESI), ESI was treated with local, oral or systemic antibiotics.
Local care consisted of gentamicin ophthalmic solution applied twice a day
plus hydrogen peroxide. The oral and IV antibiotics used were ciprofloxacin
(or ofloxacin) and ceftazidime, respectively.
The authors report a 78% cure rate for Pseudomonas-associated ESI.
In three cases cure was achieved by local care only. They claim that their
results contradict those recommended by a leading PD textbook, which
recommends catheter removal for Pseudomonas-associated ESI.
Comment: Although the use of gentamicin eye drops is interesting, in
this study there is no definition of ESI, no information on the length of
its existence, nor on the length of followup. Presumably none of these
episodes were associated with peritonitis, although this is not stated.
The leading textbook they cite certainly does recommend removal of the
catheter when Pseudomonas-ESI is associated with peritonitis.
(Stephen Vas, M.D., University of Toronto, Canada)
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17th Annual CAPD Conference
Basic peritoneal dialysis :
Peritonitis and exit-site infection