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Perit Dial Int 8(2): 155-157 1988
© 1988 International Society for Peritoneal Dialysis
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REVIEWS AND ORIGINAL ARTICLES

Relapsing Peritonitis in Continuous Ambulatory Peritoneal Dialysis (CAPD): Treatment by Interruption of CAPO and Prolonged Antibiotic Therapy

K. Shashi Kant1, Daniel Goetz2, Cynthia Marzluff2 and Denise Motz2

1 Division of Nephrology, Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio, and2 Dialysis Clinic, Inc., Cincinnati, Ohio

Correspondence to: K. Shashi Kant, Division of Nephrology, Mail Location 585, 231 Bethesda Avenue, Room 5363, Cincinnati, Ohio 45267-0585.

Relapsing peritonitis was assessed in the continuous ambulatory peritoneal dialysis (CAPD) population of a large, outpatient dialysis facility. Prolonged systemic treatment with antibiotics often fails, resulting in the eventual removal and subsequent reimplantation of the catheter. We have tried a new approach to avoid removal of the peritoneal catheter. Patients were treated by the interruption of CAPD, conversion to hemodialysis or discontinuation of dialysis for a period of 7 to 21 days while continuing systemic antibiotics. Over a period of 76.63 patient years, 69 episodes of bacterial peritonitis occurred (0.9 episodes per patient year). Of these, five episodes could be classified as relapsing peritonitis. Five patients with gram-positive relapsing peritonitis were treated by this regimen; all responded with a cure. Our results suggest that relapsing peritonitis can be eradicated without the removal of the peritoneal catheter.

KEY WORDS: Relapsing peritonitis; intraperitoneal (i.p.) antibiotic therapy; phagocytic activity; opsonins; macrophage function.

Received 3 January 1988; accepted 8 February 1988.






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