Review of Peritonitis Associated with Peritoneal Dialysis Management

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Alvaro de Jesús León Barragán
Armando Espinoza Santana
Omar González Rico
José Luis Ortiz Fernández
Jaqueline Velasco Martínez
Berenice Miranda Torres
Yadira Yamile Sánchez Marín
Arelia Itzel Maldonado Cuevas
Victor Mario Martinez Bravo

Abstract

One frequent and serious side effect of peritoneal dialysis (PD) is peritonitis. Following the acquisition of the necessary microbiologic specimens, empirical antibiotic therapy covering both Gram-positive and Gram-negative organisms (including Pseudomonas species) should be initiated when a patient on PD exhibits clinical signs consistent with PD-associated peritonitis. The best administration route is intraperitoneal. To stop subsequent fungal peritonitis, antifungal prophylaxis should be administered, ideally in the form of oral nystatin. Antibiotic therapy can be modified in accordance with the results of the PD effluent Gram stain or culture and sensitivity tests. The most recent ISPD guidelines include a thorough explanation of how each antibiotic should be used. Antibiotics are often used for two to three weeks, depending on the particular organisms that are being treated. For refractory, relapsing, or fungal peritonitis, catheter removal and interim hemodialysis support are advised. Following full resolution of the peritonitis, a new PD catheter may be placed in certain individuals. Refractory exit site or tunnel infections should also be taken into consideration while removing PD catheters. The use of PD as a first-line dialysis modality is supported by a global trend of declining PD-associated peritonitis rates following improvements in clinical management.

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Alvaro de Jesús León Barragán, Armando Espinoza Santana, Omar González Rico, José Luis Ortiz Fernández, Jaqueline Velasco Martínez, Berenice Miranda Torres, Yadira Yamile Sánchez Marín, Arelia Itzel Maldonado Cuevas, & Victor Mario Martinez Bravo. (2024). Review of Peritonitis Associated with Peritoneal Dialysis Management. International Journal of Medical Science and Clinical Research Studies, 4(01), 114–117. https://doi.org/10.47191/ijmscrs/v4-i01-26
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