Kostić S, Ljuvenović S, Velicković R, Stefanović V, Raicević R, Cukuranović R, Veljković S, Djordjević V, Malobabić Z
Institute of Nephrology, University School of Medicine, Nish.
Srp Arh Celok Lek. 1996;124 Suppl 1:149-51.
Peritonitis is a very serious complication in patients treated by CAPD. The frequent and grave episodes are the main cause for CAPD withdrawal. The effective prevention and adequate therapy of peritonitis are very important for a successful CAPD treatment. The aim of this study was to present our results of peritonitis therapy in CAPD patients using the following protocol: Vancomycin 1.0 g.i.p. immediately after the admission to the unit, 250 mg Ceftriaxon (Longaceph) after a bag exchange for seven days, and the 1.0 g Vancomycin. Using this protocol we treated 97 peritonitis episodes; 74 of them (80%) were treated successfully by this antibiotics combination. The clearness of peritoneal fluid was attained 1-3 days within 56.7% of cases, and 4-6 days within the 29.7% peritonitis episodes (86.4%). A common cause of peritonitis was Staphylococcus epidermidis episodes (28.4%), Staphylococcus aureus (13.5%), and in 39.1% episodes the cultures were sterile. Uneffective antibiotic application according to this protocol was found in cases of pseudomonas and fungal peritonitis. The mentioned antibiotic therapy had no effect in a small number of peritonitides provoked by S. epidermidis (8.7%) and S. aureus (13.0%) This required the application of a third antibiotic. It could be concluded that this antibiotic combination in treatment of peritonitis in patients on CAPD was very effective.
腹膜炎是接受持续性非卧床腹膜透析(CAPD)治疗患者的一种非常严重的并发症。频繁且严重的发作是停止CAPD治疗的主要原因。有效预防和充分治疗腹膜炎对于CAPD治疗的成功非常重要。本研究的目的是介绍我们使用以下方案治疗CAPD患者腹膜炎的结果:万古霉素1.0 g腹腔内注射,患者入院后立即给药,头孢曲松(罗氏芬)250 mg在每次换液后给药,持续7天,然后再给予1.0 g万古霉素。使用该方案我们治疗了97例腹膜炎发作;其中74例(80%)通过这种抗生素联合治疗成功。56.7%的病例在1 - 3天内腹腔液变清,29.7%的腹膜炎发作(86.4%)在4 - 6天内变清。腹膜炎的常见病因是表皮葡萄球菌感染(28.4%)、金黄色葡萄球菌感染(13.5%),39.1%的发作培养结果为无菌。在假单胞菌和真菌性腹膜炎病例中发现按照该方案应用抗生素无效。在少数由表皮葡萄球菌(8.7%)和金黄色葡萄球菌(13.0%)引起的腹膜炎中,上述抗生素治疗无效,这就需要应用第三种抗生素。可以得出结论,这种抗生素联合治疗CAPD患者的腹膜炎非常有效。