Abstract
Peritonitis is a frequent complication of continuous ambulatory peritoneal dialysis (CAPD). Intraperitoneal administration of antibiotics has been the treatment of choice in such cases. However, this procedure is cumbersome and requires hospitalization. With the advent of novel fluoroquinolones, such as ciprofloxacin (CPFX), it has become possible to treat these patients by oral administration of the drug. Between September 1 1988 and August 31 1989, we treated 5 cases of CAPD peritonitis with oral CPFX. Immediately after admission, these patients were given 800mg of CPFX. They then underwent peritoneal lavage three times. Subsequently 200mg of CPFX was given orally three times a day. The drug concentration in the plasma and the dialysate were monitored for 1 week and were kept higher than the MIC of the causative organisms which included Staphylococcus aureus, Strep. viridans, E. aerogenes, and Moraxella sp.. Infection was cleared within 8 days in all cases. However, a relapse was noted in one patient who was given aluminum-based antacids during the treatment. In this case, the concentrations of CPFX in both the plasma and the dialysate were much lower than those of other patients. We conclude that oral CPFX is effective in the treatment of CAPD peritonitis. Simultaneous administration of antacids may interfere with the effectiveness of the treatment.
