How is peritoneal dialysis infection treated?

How is peritoneal dialysis infection treated?

Mild infections may require more careful PD catheter restraints and local treatment with topical antibiotics, special cleansing solutions and/or hypertonic saline. Severe infections require antibiotics for 2-6 weeks. In cases that don’t improve, intravenous antibiotics or catheter removal may be necessary.

How is infection treated in dialysis patients?

Dialysis patients with uncomplicated catheter-related bacteremia are treated with systemic antibiotics for 3 weeks. Those with metastatic infection (eg, endocarditis or osteomyelitis) should receive 6 weeks of antibiotic therapy. Monitoring serum antibiotic concentrations is challenging in dialysis outpatients.

What is the most common complication associated with continuous ambulatory peritoneal dialysis?

Bacterial Peritonitis. Bacterial peritonitis is the most common complication of CAPD (,22). It is thought to occur with a frequency of approximately one case per patient per year and to be responsible for as many as 1.9% of deaths among patients undergoing CAPD (,23).

What should be done if peritonitis occurs in patients undergoing PD?

Treating Peritonitis Peritonitis can be easily treated with antibiotics if caught early and started quickly after the diagnosis. Antibiotics can be added to your new dialysis fluid or be taken as oral tablets. If peritonitis is not treated right away, you can develop bacteremia, which is a bloodstream infection.

How do you treat an exit site infection?

Exit site care and local dressing constitutes the cornerstone in the management of ESI. Topical antiseptics (e.g., mupirocin, gentamicin ointment) are all viable options for dressing of exit sites. Other alternatives such as hypertonic saline solution can be considered in selected cases (e.g., P. aeruginosa ESI).

Which bacteria is main responsible for infection during dialysis?

Methicillin-resistant Staphylococcus aureus (MRSA) S. aureus infection is common in dialysis patients and usually secondary to intravascular catheters, AV grafts, or peritonitis.

Can patients on dialysis take antibiotics?

Research shows 30% of patients on maintenance hemodialysis treated in the United States receive intravenous (IV) antibiotics at least once per year. Vancomycin is the most frequently used IV antibiotic in the dialysis setting, accounting for approximately 70% of initial IV antibiotic doses.

What causes infection in peritoneal dialysis?

An infection may occur during peritoneal dialysis due to unclean surroundings, poor hygiene or contaminated equipment.

What are the infectious complications of peritoneal dialysis?

Infectious complications of PD include exit-site infection (ESI), tunnel infection (TI), and peritonitis; while non-infectious complications include obstruction and malposition of PD catheters, fluid leaks, encapsulating peritoneal sclerosis (EPS), hernia, pain, and blood-stained dialysate.

What antibiotics treat peritonitis?

Risk for early peritonitis is reduced with perioperative intravenous antibiotics; other prophylactic approaches are not yet proven. In severe and hospital-acquired intra-abdominal infections, imipenem, piperacillin/tazobactam, and a combination of aminoglycosides and metronidazole are often effective.

What is the most common route of infection leading to peritonitis?

The most common pathogens are coagulase-negative staphylococcal species (eg, Staphylococcus epidermidis) that commonly colonize human skin and hands, and Staphylococcus aureus, which together are responsible for 50% or more of infections in most series. 2–4 Exit-site and tunnel infections may also lead to peritonitis.

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