Safety and efficacy of cefalexin in peritoneal dialysis patients with exit-site infections

Abstract

The normal antimicrobial dose in Japan is often lower than that administered overseas, and a similar tendency is also recognized in the treatment of dialysis patients. We investigated the safety and efficacy of cefalexin for exit-site infections through a retrospective review of peritoneal dialysis patients. The study subjects were peritoneal dialysis patients with exit-site infections who were taking cefalexin ( 500 mg ) orally twice a day in accordance with the recommendations of the International Society for Peritoneal Dialysis from January 2013 to December 2014. We evaluated each patient with multiple treatments during the research period; in total, the study had 13 patients and 20 administrations available for analysis. The average values for patient age, body weight, and peritoneal dialysis period were 55.9 ± 14.1 years, 65.4 ± 18.6 kg, and 12.4 ± 12.0 months, respectively. Causative bacteria were not identified in approximately half of the patients, but when identified, methicillin-sensitive Staphylococcus aureus was found most frequently. The average administration period for cefalexin was 20.1 ± 8.7 days. We observed a favorable therapy effect among the patients, with a 95.0% (19 / 20) efficacy rate. Therapy failure occurred in one patient for whom an ineffective antimicrobial agent was changed, as directed by the attending doctor. In terms of safety, an attending doctor clearly indicated in the medical records that cefalexin caused adverse effects, including mild diarrhea in one patient. There were no patients with abnormal laboratory values. Potential limitations of this study include the control group is not configured to evaluate the effectiveness. But since no obvious severe adverse effects were observed, even after the administration of cefalexin. Our results suggest that the drug could be administered safely.