Buradasınız

Anasayfa » Content

SAPD PERİTONİTİNİN TEDAVİSİNDE IMIPENEM/CILASTATIN

IMIPENEM/CILASTATIN TREATMENT IN CAPD PERITONITIS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1999

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objectives: In this open trial, the efficacy of imipenem/cilastatin was investigated in 88 peritonitis episodes in 50 chronic renal failure patients on continues ambulatory peritoneal dialysis (CAPD) in one year. Methods: Biphasic Castenada medium (Blood culture system), blood base agar and Me Conkey media (plate method) were used for microbiological determination. Imipenem/cilastatin was used as the empirical therapy in all patients. One g loading dose of Imipenem/cilastatin IV was given to all patients at the first day. 100 mg Imipenem/cilastatin in 2 liter dialysis solution was administered to all patients as the standard therapy for the following 9 days. Primary response was accepted to occur when PMNL number in the dialysis solution decreased to 100/mm3. Results: Primary response, relapse and overall cure rate were 93%, 4%, 89% respectively in imipenem/cilastatin treatment. Blood culture system (77%) was found to be more sensitive than plate method (43%) in isolating the micro-organisms which were as follows in order of decreasing frequency: Staphylococcus epidermidis (50%), E. Coli (17%), Staphylococcus aureus (13%) and Klebsiella spp. (7%). Conclusion: It can be concluded that Imipenem/cilastatin first-line treatment is highly efficient in CAPD peritonitis.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: Bu çalışmada, sürekli ayaktan periton dializi (SAPD) uygulanan 50 son dönem böbrek yetmezliği olan hastanın bir yıldaki 88 peritonit atağında imipenem/cilastatin tedavisinin etkinliği araştırıldı. Metod: Mikrobiyolojik inceleme için bifazik Castenada besiyeri (kan kültürü sistemi), kanlı agar ve Mc Conkey agar (plak metodu) kullanıldı. Tüm hastalara imipenem/cilastatin ampirik olarak başlandı. Tedavi, ilk gün Ig intravenöz yükleme dozu ve takip eden dokuz gün iki litre diyaliz solüsyonuna 100 mg imipenem/cilastatin olacak şekilde uygulandı. Diyaliz solüsyonundaki PMNL sayısının mm3de 100'ün altında olması primer yanıt olarak kabul edildi. Sonuçlar: imipenem/cilastatin tedavisinde, sırası ileprimeryanıt, nüks ve tamamen tedavi oranları %93, %4, %89 olarak bulundu. Mikroorganizma izolasyonu yönünden kan kültürü sistemi (%77) plak metoduna (%43) göre daha duyarlı bulundu. Staphylococcus epidermidis (50%), E. Coli (17%), Staphylococcus aureus (13%) and Klebsiella spp. (7%) en sık izole edilen mikroorganizmalardı. Sonuç: İmipenem/cilastatin, SAPD peritonitinin ampirik tedavisinde oldukça etkilidir.
FULL TEXT (PDF): 
PDF icon pdf_tndt_270.pdf
  • 4
195-199
  • Turkish

REFERENCES

References: 

1. Levison ME, Bush LM. Peritonitis and other intraabdominal infections. In Principles and practice of infectious diseases. Ed. Mandel GL, Douglas RG, Bennet JE. 3rd edition Churchill Livingstone Inc. 1990, pp 636-670.
2. Fenton S.S.A, Pei Y, Delmore T, Cattran DC, Bowman C, Johnstan N, Campbell 1, Clarke WT, Richardson RM. The CAPD peritonitis rate is not improving with time. ASAIO Trans 1986;32(l):546-9.
3. Horton MW, Deeter RG, Sherman RA. Treatment of peritonitis in patients undergoing continous ambulatory
peritoneal dialysis. Clin Pharm. 1990;9(2): 102-8.
4. Karchmer AW. Approach to the patient with infection in a prosthetic device. In Gorbach SL, Bartlett JG,
Blacklow NR (eds), Infectious Diseases, International
ed.,W.B. Saunders Company USA, 1992, pp 1374-84.
5. Hagelskjaer LH, Moller JK. Peritonitis in continous ambulatory peritoneal dialysis. An evaluation of the empiric initial antibiotic treatment. Ugeskr Leager,
1996;158(18):2532-7.
6. Moller JK, Hagelskjaer LH. Peritonitis in continuous ambulatory peritoneal dialysis. Culture of peritoneal dialysis solution fluid. Ugeskr Leager 1996;! 58(18):2538-41.
7. Lui SF, Cheng AB, Leung CB, Wong KC, Lai KN.
Imipenem/cilastatin sodium in the treatment of continuous ambulatory peritoneal dialysis-associated
peritonitis. Am J Nephrol 1994;14:182-6.
8. Sobel JD,. Imipenem and aztreonam. Infect Dis Clin
North Am. 1989;3:613.
9. Wilson SE. Carbapenems: Monotherapy in intraabdominal sepsis. Scand J Infect Dis. suppl
1995;96:28.
10. Chan CY, Lai KN, Lam AW, Li PK, Chung WWM,
French GL. Pharmacokinetics of parenteral imipenem/cilastatin in patients on continuous ambulatory peritoneal dialysis. Journal of Antimicrobial
Chemotherapy 1991;27:225-32.
11. Saklayen MG. CAPD peritonitis, incidence, pathogens, diagnosis and management. Med Clin North Am
1990;74(4):997-1010.
12. Levision ME, Bush LM. Peritonitis and other intra-abdominal infections. In Mandell GL, Douglas RG, Bennet JE (eds), Principles and Practice of Infectious Diseases, 3rd ed., Churchill Livingstone UK, 1990, pp
636-670.
13. Hachler H, Vogt K, Binswanger U, von Graevenitz A: Centrifugation of 50 ml of peritoneal fluid is sufficient for microbiological examination in continuous ambulatory Peritoneal dialysis patients with peritonitis.
Infection 1986;14:102-4.
14. Holley JL, Bernardini J, Piraino B: Continuous cycling peritoneal dialysis is associated with lower rates of catheter infections than continuous ambulatory .peritoneal dialysis. Am J Kidney Dis 1990; 16:133.
15. Males BM, Walshe JJ, Garinger L. Addi-Check
filtration, BACTEC and 10 ml culture methods for recovery of micro-organisms from dialysis effluent
during episodes of peritonitis. J Clin Microbiol 1986;23:350.
16. Poole-Warren LA, Taylor PC, Fannel PC. Laboratory diagnosis of peritonitis in patients treated with continuous ambulatory peritoneal dialysis. Pathology 1986;18:237-9.
17. Taylor PC, Poole-Warren LA, Grundy RE. Increased microbial yield from continuous ambulatory peritoneal dialysis effluent after chemical or physical Distruption of
Phagocytes. J Clin Microbiol 1987;25:580-3.
18. Lye WC, Wong PL, Leong SO, Lee WJ. Isolation of
organisms in CAPD peritonitis: a comparison of two
techniques. Adv Perit Dial 1994;10:166-8.
19. Holley JL, Moss AH. A prospective evaluation of blood culture versus standard plate tecniques for diagnosis peritonitis in continuous ambulatory peritoneal dialysis.
Am J Kidney Dis 1989; 13(3): 184-8.
20. Beaman M, Solaro L, McGonigle RJS, Micheal J, Adu
D. Vankomycin and ceftazidime in the treatment of
CAPD peritonitis. Nephron 1989;51:51-5.
21. Bistrup C, Siboni AH, Pedersen RS. Peritonitis among patients treated with continuous ambulatory peritoneal
dialysis. Ugeskr Leager, 1995; 157(28):4023-6.
22. Lupo A, Rugiu C, Bernich P, Laudon A, Marcantoni C, Mosconi G, Cantaluppi MC, Maschio G. A prospective, randomised trial of two antibiotic regimens in the treatment of peritonitis in CAPD patients: teicoplanin plus tobramycin versus cephalothin plus tobramycin. J
Antimicrob Chemother 1997;40(5):729-32.
23. Vas SI. Treatment of Peritonitis. Peritoneal Dialysis
International, 1994;14(3):49-55.
24. Gucek A, Bren AF, Hergouth V, Lindic J. Cefazolin and netilmycin versus vancomycin and ceftazidime in the treatment of CAPD peritonitis. Adv Perit Dial 1997;13:218-20.
25. Yen CJ, Tsai TJ, Chen HS, Fang CC, Yang CC, Lee PH, Lin RH, Tsai KS, Hung KY, Yen TS. Effects of
intraperitoneal antibiotics on human peritoneal
mesothelial cell growth. Nephron 1996;74(4):694-700.
26. Merchant MR, Anwar N, Were A, Uttley L, Tooth JA,
Gokal R. Imipenem/cilastatin versus netilmicin and vancomycin in the treatment of CAPD peritonitis. Adv
Perit Dial 1992;8:234-7.
199

Thank you for copying data from http://www.arastirmax.com