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Article: Cefazolin plus netilmicin versus cefazolin plus ceftazidime for treating CAPD peritonitis: Effect on residual renal function

TitleCefazolin plus netilmicin versus cefazolin plus ceftazidime for treating CAPD peritonitis: Effect on residual renal function
Authors
KeywordsAminoglycosides
Antibiotic
Continuous ambulatory peritoneal dialysis
Peritonitis
Residual renal function
Issue Date2005
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ki/index.html
Citation
Kidney International, 2005, v. 68 n. 5, p. 2375-2380 How to Cite?
AbstractBackground. The International Society for Peritoneal Dialysis (ISPD) treatment guidelines for continuous ambulatory peritoneal dialysis (CAPD) peritonitis 2000 recommended the use of cefazolin plus ceftazidime as the initial empirical therapy in patients with residual renal function (RRF). However, this treatment regimen has not been compared with the conventional regimen of cefazolin plus netilmicin in prospective, randomized controlled trials. Methods. Stable CAPD patients who developed clinical evidence of peritonitis were randomized to receive intraperitoneal (i.p.) cefazolin plus netilmicin or cefazolin plus ceftazidime once daily in the long dwell for 14 days. For patients with RRF (>1 mL/minute) before entry into the study (N = 50), RRF and 24-hour urine volume were measured at days 1, 14, and 42 after commencement of i.p. antibiotic treatment. Results. One hundred and two patients were recruited into the study. The primary cure rates of i.p. cefazolin plus netilmicin and cefazolin plus ceftazidime were 66.7% and 64.7%, respectively. The overall cure rate for the 2 treatment regimens was 82.3% for both. Seven patients (14%) from each treatment group required removal of the dialysis catheters due to treatment failure. Relapse of peritonitis occurred in 2 patients (4%) in both treatment groups. Thirty-six patients with RRF at baseline achieved primary cure of their peritonitis by the assigned antibiotics. In this subgroup of patients, their RRF and daily urine volume showed significant reduction at day 14 and returned to near baseline values at day 42. The degree of reduction in RRF and urine volume did not differ significantly between the patients treated with cefazolin plus netilmicin and cefazolin plus ceftazidime. Conclusion. Intraperitoneal cefazolin plus netilmicin and cefazolin plus ceftazidime have similar efficacy as empirical treatment for CAPD peritonitis. In CAPD patients with RRF, significant but reversible reduction in RRF and 24-hour urine volume could occur after an episode of peritonitis, despite successful treatment by i.p. antibiotics. The effect of i.p. cefazolin plus netilmicin, or i.p. cefazolin plus ceftazidime on RRF in CAPD patients with peritonitis does not appear to be different. Our findings do not support the routine use of cefazolin and ceftazidime as the empirical treatment for CAPD peritonitis. © 2005 by the International Society of Nephrology.
Persistent Identifierhttp://hdl.handle.net/10722/77838
ISSN
2015 Impact Factor: 7.683
2015 SCImago Journal Rankings: 3.181
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSing, LLen_HK
dc.contributor.authorSuk, WCen_HK
dc.contributor.authorNg, Fen_HK
dc.contributor.authorSuk, YNen_HK
dc.contributor.authorKit, MWen_HK
dc.contributor.authorYip, Ten_HK
dc.contributor.authorKai, CTen_HK
dc.contributor.authorMan, FLen_HK
dc.contributor.authorKar, NLen_HK
dc.contributor.authorWai, KLen_HK
dc.date.accessioned2010-09-06T07:36:17Z-
dc.date.available2010-09-06T07:36:17Z-
dc.date.issued2005en_HK
dc.identifier.citationKidney International, 2005, v. 68 n. 5, p. 2375-2380en_HK
dc.identifier.issn0085-2538en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77838-
dc.description.abstractBackground. The International Society for Peritoneal Dialysis (ISPD) treatment guidelines for continuous ambulatory peritoneal dialysis (CAPD) peritonitis 2000 recommended the use of cefazolin plus ceftazidime as the initial empirical therapy in patients with residual renal function (RRF). However, this treatment regimen has not been compared with the conventional regimen of cefazolin plus netilmicin in prospective, randomized controlled trials. Methods. Stable CAPD patients who developed clinical evidence of peritonitis were randomized to receive intraperitoneal (i.p.) cefazolin plus netilmicin or cefazolin plus ceftazidime once daily in the long dwell for 14 days. For patients with RRF (>1 mL/minute) before entry into the study (N = 50), RRF and 24-hour urine volume were measured at days 1, 14, and 42 after commencement of i.p. antibiotic treatment. Results. One hundred and two patients were recruited into the study. The primary cure rates of i.p. cefazolin plus netilmicin and cefazolin plus ceftazidime were 66.7% and 64.7%, respectively. The overall cure rate for the 2 treatment regimens was 82.3% for both. Seven patients (14%) from each treatment group required removal of the dialysis catheters due to treatment failure. Relapse of peritonitis occurred in 2 patients (4%) in both treatment groups. Thirty-six patients with RRF at baseline achieved primary cure of their peritonitis by the assigned antibiotics. In this subgroup of patients, their RRF and daily urine volume showed significant reduction at day 14 and returned to near baseline values at day 42. The degree of reduction in RRF and urine volume did not differ significantly between the patients treated with cefazolin plus netilmicin and cefazolin plus ceftazidime. Conclusion. Intraperitoneal cefazolin plus netilmicin and cefazolin plus ceftazidime have similar efficacy as empirical treatment for CAPD peritonitis. In CAPD patients with RRF, significant but reversible reduction in RRF and 24-hour urine volume could occur after an episode of peritonitis, despite successful treatment by i.p. antibiotics. The effect of i.p. cefazolin plus netilmicin, or i.p. cefazolin plus ceftazidime on RRF in CAPD patients with peritonitis does not appear to be different. Our findings do not support the routine use of cefazolin and ceftazidime as the empirical treatment for CAPD peritonitis. © 2005 by the International Society of Nephrology.en_HK
dc.languageengen_HK
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ki/index.htmlen_HK
dc.relation.ispartofKidney Internationalen_HK
dc.subjectAminoglycosidesen_HK
dc.subjectAntibioticen_HK
dc.subjectContinuous ambulatory peritoneal dialysisen_HK
dc.subjectPeritonitisen_HK
dc.subjectResidual renal functionen_HK
dc.titleCefazolin plus netilmicin versus cefazolin plus ceftazidime for treating CAPD peritonitis: Effect on residual renal functionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0085-2538&volume=68&issue=5&spage=2375&epage=2380&date=2005&atitle=Cefazolin+plus+netilmicin+versus+cefazolin+plus+ceftazidime+for+treating+CAPD+peritonitis:+effect+on+residual+renal+functionen_HK
dc.identifier.emailKar, NL: knlai@hku.hken_HK
dc.identifier.authorityKar, NL=rp00324en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1523-1755.2005.00700.xen_HK
dc.identifier.pmid16221243-
dc.identifier.scopuseid_2-s2.0-30944451169en_HK
dc.identifier.hkuros121471en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-30944451169&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume68en_HK
dc.identifier.issue5en_HK
dc.identifier.spage2375en_HK
dc.identifier.epage2380en_HK
dc.identifier.isiWOS:000232388800079-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridSing, LL=36895702500en_HK
dc.identifier.scopusauthoridSuk, WC=11639283900en_HK
dc.identifier.scopusauthoridNg, F=7103125634en_HK
dc.identifier.scopusauthoridSuk, YN=11639747900en_HK
dc.identifier.scopusauthoridKit, MW=11638978700en_HK
dc.identifier.scopusauthoridYip, T=7004283977en_HK
dc.identifier.scopusauthoridKai, CT=11639402900en_HK
dc.identifier.scopusauthoridMan, FL=11640357700en_HK
dc.identifier.scopusauthoridKar, NL=7402135706en_HK
dc.identifier.scopusauthoridWai, KL=11640685300en_HK
dc.identifier.citeulike344748-

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