Evaluation of perioperative antibiotics at the time of dialysis catheter placement |
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Authors: | Kathleen M Sardegna Anne M Beck C Frederic Strife |
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Institution: | (1) Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio, USA, US |
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Abstract: | The effect of prophylactic antibiotics on the occurrence of peritonitis in the 14 days following surgical peritoneal dialysis
catheter placement was evaluated. Medical records from 73 pediatric patients who had 89 Tenckhoff catheters inserted over
6 years were reviewed. Twelve catheter procedures were excluded for rapid catheter loss, unavailable charts, eosinophilic
peritonitis, and antibiotic administration >3 h postoperatively. Chi-squared analysis for non-continuous variables compared
factors at the time of catheter placement with outcome (peritonitis). Thirteen patients developed postoperative peritonitis
when 77 catheter insertions were analyzed (17%). Peritonitis was significantly more common in patients who did not receive
perioperative antibiotics (7 of 16 catheter placements) (λ2 = 12.48, P≤0.001). The reduced incidence of peritonitis was not specific to any one antibiotic class. Using step-wise logistic regression
analysis, no association was found between peritonitis incidence and nephrotic syndrome, immunosuppression, recent surgery
(<14 days), acute versus chronic use, year of catheter placement, surgeon, or patient age. Catheter type, implantation technique,
exit site care, and operative wound care did not vary. These results indicate that perioperative peritonitis episodes can
be significantly reduced by the use of prophylactic antibiotics prior to or at the time of surgery.
Received August 27, 1996; received in revised form and accepted October 2, 1997 |
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Keywords: | : Peritonitis Prophylactic antibiotics Dialysis |
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