Rusthoven E, Monnens L A, Schröder C H
Department of Pediatrics, Wilhelmina Children's University Hospital, Utrecht, The Netherlands.
Perit Dial Int. 2001 Jul-Aug;21(4):386-9.
To evaluate the use of the combination of cefazolin and ceftazidime for initial treatment of peritoneal dialysis (PD)-related peritonitis in pediatric patients.
Retrospective nonrandomized study.
Pediatric dialysis units of the University Medical Center of Utrecht and Nijmegen, The Netherlands.
40 children (median age 5.4 years) who were treated with PD during the study period of 4.5 years.
All 50 episodes of peritonitis that occurred during the study period were evaluated by review of medical records. Patients were given intraperitoneal ceftazidime 500 mg/L dialysis fluid, and cefazolin 500 mg/L as a loading dose, followed by a maintenance dose of ceftazidime 125 mg/L and cefazolin 100 mg/L, intraperitoneally, 4 times daily. Antibiotics were continued for 14 days.
After identification of the causative microorganism, one of the antibiotics was discontinued in 34 cases, and the antibiotic schedule was adapted in 2 cases. All cases were initially cured within 3 days. In 5 cases (10%), there was a peritonitis with the same organism recurring within 2 weeks after completion of treatment. There were 4 cases of PD-related peritonitis caused by pseudomonas, all of which were cured.
The antibiotic combination of cefazolin and ceftazidime is effective for the initial therapy of PD-related peritonitis in children. The toxic complications of aminoglycosides are avoided with this combination.
评估头孢唑林和头孢他啶联合用药用于小儿患者腹膜透析（PD）相关腹膜炎初始治疗的效果。
回顾性非随机研究。
荷兰乌得勒支大学医学中心和奈梅亨大学医学中心的儿科透析单元。
40名儿童（中位年龄5.4岁），在4.5年的研究期间接受PD治疗。
通过查阅病历对研究期间发生的50例腹膜炎进行评估。患者接受腹膜内注射头孢他啶，剂量为500 mg/L透析液，头孢唑林500 mg/L作为负荷剂量，随后维持剂量为头孢他啶125 mg/L和头孢唑林100 mg/L，每日4次腹膜内注射。抗生素持续使用14天。
确定致病微生物后，34例停用其中一种抗生素，2例调整抗生素用药方案。所有病例最初均在3天内治愈。5例（10%）在治疗完成后2周内出现同一病原体引起的腹膜炎复发。有4例由假单胞菌引起的PD相关腹膜炎，均治愈。
头孢唑林和头孢他啶联合抗生素对小儿PD相关腹膜炎的初始治疗有效。该联合用药避免了氨基糖苷类药物的毒性并发症。
