Hornstrup M K, Nielsen T G, Gahrn-Hansen B, Pedersen F B, Klausen M
Odense Sygehus, klinisk mikrobiologisk afdeling og nefrologisk afdeling Y.
Ugeskr Laeger. 1993 Nov 8;155(45):3650-4.
To evaluate the initial antibiotic regime of cephalothin monotherapy in the treatment of peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD), the frequency of peritonitis was registered retrospectively together with the frequency of recurrent episodes and change of antibiotic. A median frequency of 0.96 episodes per year of dialysis was found. In 24% of the episodes no microorganism was cultured. 82% of the microorganisms were gram-positive cocci, 17% gram-negative rods. The frequency of recurrent episodes was 7%. The initial antibiotic treatment with cephalothin had to be changed in 33% of the cases due to microbial resistance. In another 33% the antibiotic treatment was changed to something with a narrower spectrum. More than one third of the resistant microorganisms were methicillin-resistant coagulase-negative staphylococci. With quick and reliable microbiological diagnostic technique that makes it possible to change the antibiotic treatment early, we find cephalothin to be a suitable initial monotherapy.
为评估头孢噻吩单一疗法作为持续性非卧床腹膜透析（CAPD）患者腹膜炎初始抗生素治疗方案的效果，我们回顾性记录了腹膜炎的发生频率、复发频率以及抗生素的更换情况。结果发现，每年透析的腹膜炎发作频率中位数为0.96次。在24%的发作病例中未培养出微生物。82%的微生物为革兰氏阳性球菌，17%为革兰氏阴性杆菌。复发频率为7%。由于微生物耐药，33%的病例不得不更换头孢噻吩的初始抗生素治疗方案。另外33%的病例则更换为抗菌谱更窄的抗生素治疗。超过三分之一的耐药微生物是耐甲氧西林凝固酶阴性葡萄球菌。凭借快速可靠的微生物诊断技术，使得早期更换抗生素治疗成为可能，我们发现头孢噻吩是一种合适的初始单一疗法。
