Abstract
Vancomycin (VCM) is widely used throughout most of the world to treat gram-positive bacterial peritonitis and exit site infection (ESI) in CAPD patients; however it is not commonly used in Japan. We used intravenous (IV) VCM to treat ESI from October 1986 to September 1988 because most of the organisms responsible for ESI are gram-positive bacteria (GPB). A total of 55 ESI patients receiving CAPD were evaluated by routine check-ups in our OPC every two weeks or every month. The ESI patients received 20mg of VCM per kg in 250ml of 5% glucose IV over 1 hour, and the same dose was repeated every week for three or four weeks. During that period there were 33 episodes of ESI in 55 patients with an incidence of one episode every 24.1 patient-months. The organisms most responsible were GPB (87.9%: Staphylococcus aureus 24, S. epidermidis 3, Corynebacterium sp. 2). These were responsible for 29 of the 33 episodes. Overall, IV VCM was effective in 27 (81.8%) of 33 ESI episodes. It was effective in 27 (93.1%) of 29 patients with ESI due to GPB. The incidence of ESI in our hospital was higher than that in American or European studies. The humid atmosphere in Japan may play a role in the development of ESI. We found that IV VCM is an effective treatment for ESI.
