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Abstract: FR-PO504

Prophylactic Oral Antibiotics for Post-Endoscopic Peritonitis in Peritoneal Dialysis Patients

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Oka, Hideaki, Matsuyama Red Cross Hospital, Matsuyama, Japan
  • Iwamoto, Takaki, Matsuyama Red Cross Hospital, Matsuyama, Japan
  • Fukumitsu, Kento, Matsuyama Red Cross Hospital, Matsuyama, Japan
Background

Gastrointestinal endoscopy (GIE), especially lower GIE, is a risk factor for peritoneal dialysis (PD)-related peritonitis. However, there are currently no recommendations regarding preventive antibiotic regimens for GIE-associated peritonitis.

Methods

We retrospectively reviewed the association between prophylactic oral antibiotic administration and GIE-associated peritonitis.

Results

Among 140 patients who received PD treatment in our hospital from April 2008 to March 2018, 91 patients underwent a total of 360 GIEs, excluding patients who received therapeutic antibiotics for exit-site or other infections. None of the 30 GIEs (0%) (1 upper, 29 lower) accompanied by prophylactic oral antibiotic use led to PD-related peritonitis. The oral antibiotics included levofloxacin (n=24, 80%), amoxicillin-clavulanic acid (n=4, 13%) and others (n=2, 7%). In contrast, two of the 330 GIEs (0.6%) conducted without prophylaxis (1/289 upper, 0.3%, 1/41 lower, 2.4%) resulted in PD-related peritonitis, including one upper GIE procedure involving biopsy and one lower GIE involving oral double-balloon enteroscopy for suspected small intestinal bleeding. The incidence of peritonitis following upper GIE with invasive procedures was 1.0% (1/104), similar to past reports, and the incidence of peritonitis following lower GIE with or without invasive procedures was 2.4%, which was lower than previously reported.

Conclusion

Although it was not possible to show any significant effect of prophylactic oral antibiotics on the frequency of total GIE-associated peritonitis because of the small numbers, we could not conclude that prophylactic antibiotics were not beneficial in patients undergoing lower GIE. The administration of prophylactic oral antibiotics covering Enterobacteriaceae may thus be a convenient and promising option for preventing GIE-associated peritonitis.