Antimicrobial agents for preventing peritonitis in peritoneal dialysis patients
Sübutlu məlumatların xülasələri
23.09.2014 • Sonuncu dəyişiklik 23.09.2014
Editors
Nasal, oral, topical, or intraperitoneal antibiotics may not reduce exit-site/tunnel infection, peritonitis or catheter removal in peritoneal dialysis patients compared with placebo or no treatment. Oral antifungal prophylaxis compared with placebo/no treatment may reduce the risk of fungal peritonitis.
A Cochrane review included 39 studies with a total of 4 435 subjects. Nasal antibiotics compared with placebo or no treatment did not reduce infection rate or catheter removal . Neither did oral, topical or intraperitoneal antibiotics or topical disinfectants reduce infections or catheter removals. . Antifungal prophylaxis with oral nystatin/fluconazole compared with placebo/no treatment may reduce the risk of fungal peritonitis occurring after a patient has had an antibiotic course (2 studies, 817 patients, low quality evidence: RR 0.28, 95% CI 0.12 to 0.63).
Nasal antibiotics versus placebo/no treatment for preventing peritonitis in peritoneal dialysis patients
| Outcome | Relative effect (95% CI) | Assumed risk - Control- Placebo or no treatment | Risk with intervention (95% CI) | No of participants
(studies) Quality of evidence |
| Peritonitis (number of patients with one or more episodes) | RR 0.94
(0.67 to 1.31) | 331 per 1000 | 311 per 1000
(222 to 434) | 338 (3) Low |
| Exit-site/tunnel infection (number of patients with one or more episodes) | RR 1.34
(0.62 to 2.87) | 188 per 1000 | 252 per 1000
(117 to 540) | 338 (3) Low |
| Catheter removal or replacement (number of patients) | RR 0.92
(0.48 to 1.78) | 265 per 1000 | 244 per 1000
(127 to 472) | 289 (2) Low |
Oral or topical or intraperitoneal antibiotics versus placebo/no treatment for preventing peritonitis in peritoneal dialysis patients
| Outcome | Relative effect (95% CI) | Assumed risk - Control- Placebo or no treatment | Risk with intervention (95% CI) | No of participants
(studies) Quality of evidence |
| Peritonitis (number of patients with one or more episodes) | RR 0.82
(0.57 to 1.19) | 385 per 1000 | 316 per 1000
(219 to 458)
| 395 (5) Low |
| Exit-site/tunnel infection (number of patients with one or more episodes) | RR 0.45
(0.19 to 1.04) | 231 per 1000 | 104 per 1000
(44 to 240) | 191 (3) Low |
| Catheter removal or replacement (number of patients) | RR 0.82
(0.46 to 1.46) | 156 per 1000 | 128 per 1000
(72 to 228) | 395 (5) Low |
Topical disinfectants versus standard care or other active treatment (antibiotic or other disinfectant) for preventing peritonitis in peritoneal dialysis patients
| Outcome | Relative effect (95% CI) | Assumed risk - Control- Placebo or no treatment | Risk with intervention (95% CI) | No of participants
(studies) Quality of evidence |
| Peritonitis (number of patients with one or more episodes) | RR 0.83
(0.65 to 1.06) | 152 per 1000 | 126 per 1000
(99 to 161) | 853 (6) Low |
| Exit-site/tunnel infection (number of patients with one or more episodes) | RR 0.97
(0.74 to 1.27) | 222 per 1000 | 215 per 1000
(164 to 282) | 913 (7) Low |
| Catheter removal or replacement (number of patients) | RR 0.89
(0.57 to 1.38) | 93 per 1000 | 83 per 1000
(53 to 128) | 792 (6) Low |
Comment: The quality of evidence is downgraded by limitations in study quality (unclear allocation concealment and blinding, incomplete outcome reporting, and selective outcome reporting).
Ədəbiyyat
- Campbell D, Mudge DW, Craig JC et al. Antimicrobial agents for preventing peritonitis in peritoneal dialysis patients. Cochrane Database Syst Rev 2017;4():CD004679.