Clinical Pharmacology of Antibiotics: The Use of Intraperitoneal Antibiotics to Treat Dialysis-Associated Peritonitis

Abstract

Peritoneal dialysis has been successfully used in treating patients with end stage renal disease (ESRD) for approximately 40 years. Peritoneal infections are a frequent consequence of this procedure which has diminished its acceptance by physicians and patients alike. Since the development of an improved access catheter and automated dialysate delivery devices, peritoneal analysis has been gaining widespread acceptance as an alternative to hemodialysis in the treatment of patients with ESRD. Despite the improvement in the peritoneal dialysis systems, peritonitis continues to be a major complication for adult and pediatric patients undergoing continuous ambulatory peritoneal dialysis (CAPD).:‘-’ Although most patients have from less than one to four peritonitis episodes per year, some patients have no episodes of' peritonitis or have a significantly high occurrence (greater than four episodes) of peritonitis. Several reports have indicated that two thirds of the total number of ‘peritonitis episodes is due to gram-positive bacteria. Gram-negative bacteria accounts for approximately 15% and fungal infections account for less than 5%.