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Forum Name: Dialysis

Question: Peritonitis in CAPD patients


 Anonymous - Fri Mar 07, 2003 10:26 pm

My mother was diagnosed with peritonitis on 4-9-02 (Tues.) due to being on peritoneal dialysis. The antibiotic that her physician chose to treat it was anceft (not sure if proper spelling). It has been 6 days and she is not better. Is this the proper antibiotic????
 Anonymous - Fri Mar 07, 2003 10:27 pm

There is more than one way to skin a cat and only the physician who is familiar with your mother's case can answer this. Perhaps he knows something I don't, maybe he already knows the organism from a prior episode or from a gram stain. In general Ancef is a wonderful antibiotic but it works best when combined with an "aminoglycoside" for initial treatment. In other words I would have chosen teo antibiotics, one Ancef and then another to complement Ancef.

The fact that your mom's peritonitis is not better in six days further supports the theory that the antibiotic choice is not correct altogether. However, one must consider two other scenarios. Perhaps your mother has a fungal infection or an infection that is so strong that it requires removal of the catheter. At this point I would probably remove her catheter and add a second drug if not antifungals.

The key to this case seems to be the initial culture and cell count as well as proper identification of the organism. If these were blurry I would opt to expand coverage to more antibiotics or remove the catheter depending on the patient's condition.

Mark LaGatta
 Dr Robert James - Wed Jan 28, 2004 5:53 am

Pl check with the treating physician, u may ask him politely about the reports.
Culture- blood and local swab, etc culture reports and the sensitivity reports.
I am sure he must have done it. But medicines(antibiotics) in patients on
dialysis are started based on c/s report and to to cover a broad spectrum
of organisms.

Regards

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