Grosman Mònica D, Mosquera Vanesa M, Hernandez Maria G, Agostini Silvana, Adragna Marta, Sojo Ernesto T
Nephrology Department, Garrahan Pediatric Hospital, Buenos Aires, Argentina.
Adv Perit Dial. 2005;21:148-50.
In a previous communication, we demonstrated that, in the prevention of exit-site infection (ESI) in children, the cleansing agent 50% Amuchina (electrolytic chloroxidizer. Amuchina SpA, Genoa, Italy) is more effective than 10% povidone iodine and as effective as 4% chlorhexidine, but with fewer adverse secondary effects. In the present study, we assessed, in an Argentine pediatric population, whether Amuchina 3% is as effective as Amuchina 50% in preventing ESI in children on chronic peritoneal dialysis. In an open-label, single-center prospective study, 27 children (mean age: 7.2 years; range: 1.7-17 years) used 3% Amuchina as a cleansing agent for the daily care of a healthy exit site. Of the 27 children, 14 were switched from 50% Amuchina to 3% Amuchina, and 13 were using the 3% Amuchina for the first time. The control group consisted of 18 patients who had previously used 50% Amuchina as a cleansing agent. We followed the recommendations of the International Society for Peritoneal Dialysis with regard to exit-site care, which include keeping the cleansing agent out of the sinus and rinsing the exit site with sterile water. Amuchina was used from the first post-implantation care of the exit site. No adverse secondary effects were seen with the use of Amuchina at either concentration. Patients using 3% Amuchina presented an ESI rate similar to that of patients using Amuchina 50%. The cost of 3% Amuchina was significantly lower than that of the 50% concentration, and it was even lower than the cost for 10% povidone iodine or 4% chlorhexidine. Although more research trials are needed to assess the efficacy of 3% Amuchina, we conclude that 3% Amuchina is the best and most cost-effective cleansing agent for the daily care of a healthy exit site in children on chronic peritoneal dialysis.
在之前的一篇通讯中，我们证明，在预防儿童出口部位感染（ESI）方面，清洁制剂50% Amuchina（电解氯氧化剂，意大利热那亚的Amuchina SpA公司生产）比10%聚维酮碘更有效，且与4%氯己定效果相当，但不良副作用更少。在本研究中，我们在阿根廷儿科人群中评估了3% Amuchina在预防慢性腹膜透析儿童的ESI方面是否与50% Amuchina一样有效。在一项开放标签、单中心前瞻性研究中，27名儿童（平均年龄：7.2岁；范围：1.7 - 17岁）使用3% Amuchina作为健康出口部位日常护理的清洁制剂。在这27名儿童中，14名从50% Amuchina转换为3% Amuchina，13名首次使用3% Amuchina。对照组由18名之前使用50% Amuchina作为清洁制剂的患者组成。我们遵循了国际腹膜透析学会关于出口部位护理的建议，包括避免清洁制剂进入窦道并用无菌水冲洗出口部位。从出口部位植入后的首次护理开始使用Amuchina。两种浓度的Amuchina使用过程中均未观察到不良副作用。使用3% Amuchina的患者的ESI发生率与使用50% Amuchina的患者相似。3% Amuchina的成本显著低于50%浓度的成本，甚至低于10%聚维酮碘或4%氯己定的成本。尽管需要更多的研究试验来评估3% Amuchina的疗效，但我们得出结论，3% Amuchina是慢性腹膜透析儿童健康出口部位日常护理的最佳且最具成本效益的清洁制剂。
