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Abstract: FR-PO534

Antibiotic Prophylaxis for Tenckhoff Catheter Insertion: A Prospective Randomized Controlled Trial

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis


  • Tanasiychuk, Tatiana, Carmel Medical Center, Haifa, Haifa, Israel
  • Kushnir, Daniel, Carmel Medical Center, Haifa, Haifa, Israel
  • Sura, Oleg, Carmel Medical Center, Haifa, Haifa, Israel
  • Mendelovich, Ilona, Carmel Medical Center, Haifa, Haifa, Israel
  • Frajewicki, Victor, Carmel Medical Center, Haifa, Haifa, Israel

The incidence of early (postoperative) peritonitis after catheter insertion was described as high as 17%. Current guidelines recommend intravenous (IV) preoperative antibiotic prophylaxis. For the last 20 years, our protocol includes a single dose of Cefazoline administered intraperitoneally (IP) through the Tenckhoff catheter immediately after its insertion. Our previous retrospective study (2016) showed the effectiveness of this protocol. Over the past years, we conducted a prospective randomized trial using the same protocol of Cefazoline prophylaxis. The aim of the trial is to compare the effectiveness of both methods of prophylaxis


The trial includes all adult patients at our Institution who were candidates for peritoneal catheter insertion, able to give informed consent, without history of antibiotic use in the two weeks prior to the procedure and without history of allergy to cephalosporines. The study has two arms: intravenous preoperative or intraperitoneal postoperative, while in both arms we used the same dose (1 gr) of Cefazoline. Follow-up period was 2 weeks after the catheter insertion procedure


From March 8, 2017 - December 15, 2021 sixty two patients were included in the trial, the IP group included 30 individuals and the IV arm 32 persons. Mean age was 64.7 years (31-87), 64.5% were male and 56.5% were diabetics. A percutaneous insertion was done in 95% of the procedures, only 5% surgical. Patient's characteristics were similar in both groups. Twenty four percent of patients were Staphylococcus aureus nose carriers (37% in IP arm and 13% in IV arm) and received antibiotical topical prophylaxis. Two cases of peritonitis (3%) were recorded, without difference between the groups (one in each group).


Taking in count the relatively small size sample of one single center, early results of our study support the hypothesis of non-inferiority effectiveness of IP postoperative Cefazolin administration in comparison to IV preoperative for early peritonitis prophylaxis after percutaneous peritoneal catheter insertion.