Tapson J S, Orr K E, George J C, Stansfield E, Bint A J, Ward M K
Department of Nephrology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK.
J Antimicrob Chemother. 1990 Dec;26 Suppl F:63-71. doi: 10.1093/jac/26.suppl_f.63.
This report describes a prospective, randomized comparison of oral ciprofloxacin and intraperitoneal vancomycin/netilmicin in the treatment of 50 consecutive episodes of CAPD peritonitis in 35 patients. Successful cure of peritonitis was achieved in 76% of subjects taking oral ciprofloxacin and 72% of those given intraperitoneal antibiotics. Satisfactory concentrations of ciprofloxacin in dialysate were achieved in all patients. Failure of ciprofloxacin was due to persistence of an isolate of intermediate sensitivity (1), to persistence with acquisition of resistance (1), and to relapse/reinfection in the remaining four cases (with resistant or moderately sensitive strains in three cases). Ciprofloxacin was well tolerated in the majority of cases. A significant rise in serum creatinine was noted in almost all patients taking oral ciprofloxacin. The advantages of oral drug administration indicate that oral ciprofloxacin is the preferred first-line treatment of CAPD-associated peritonitis.
本报告描述了对35例患者连续50次持续性非卧床腹膜透析（CAPD）腹膜炎发作采用口服环丙沙星与腹腔注射万古霉素/奈替米星进行前瞻性随机对照研究的情况。口服环丙沙星的患者中76%以及接受腹腔内抗生素治疗的患者中72%的腹膜炎获得成功治愈。所有患者透析液中环丙沙星浓度均达到满意水平。环丙沙星治疗失败的原因包括1例中度敏感菌株持续存在、1例出现耐药性后持续感染，其余4例复发/再感染（3例为耐药或中度敏感菌株）。多数病例中环丙沙星耐受性良好。几乎所有口服环丙沙星的患者血清肌酐均显著升高。口服给药的优势表明，口服环丙沙星是CAPD相关性腹膜炎首选的一线治疗药物。
