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Abstract: FR-OR081

Oral Antibiotic Therapy and Hospitalization in Peritoneal Dialysis-Associated Peritonitis

Session Information

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Lazar, Rachael, DaVita Inc, Denver, Colorado, United States
  • Zywno, Meredith L., DaVita Inc, Denver, Colorado, United States
  • Shapiro, Mark H., DaVita Inc, Denver, Colorado, United States
  • Weinhandl, Eric D., Davita Clinical Research, Minneapolis, Minnesota, United States
  • Naljayan, Mihran V., DaVita Inc, Denver, Colorado, United States

Group or Team Name

  • DaVita Patient Safety Organization, Denver, CO.
Background

During peritoneal dialysis (PD), peritonitis (PTN) can result in hospital admission or permanent discontinuation of PD. When a patient experiences PTN symptoms outside clinic hours, immediate initiation of intraperitoneal (IP) antibiotics may be infeasible. We assess whether use of a one-time (“bridge”) oral antibiotic may improve outcomes in this setting.

Methods

We conducted a case-control study to assess the impact of oral antibiotic therapy (OBT) on hospitalization for PTN, relative to PTN not requiring hospitalization. Cases were accrued from 6/1/23 to 7/31/24 among PD patients at a large dialysis provider and defined by hospitalization within 30 days of PTN diagnosis. Controls were non-hospitalized PTN events. Case-control pairs (N=741) were matched on demographic and clinical factors.

Results

OBT use was documented in 31% of PTN events (total N=2981) during the 13-month period. A lower proportion of hospitalized cases (28%) versus non-hospitalized controls (31%) used OBT, although this association was not significant (OR=0.86, 95% CI: 0.69,1.08). The protective effect of OBT use on hospitalization was significant for events with gram-positive culture (OR=0.72, 95% CI: 0.56,0.92).

Conclusion

Use of an oral antibiotic was associated with lower odds of hospitalization after a PTN diagnosis, particularly for events associated with a gram-positive organism. These results suggest that patients with suspected PTN may benefit from oral antibiotic therapy as a bridge to IP antibiotics.

Digital Object Identifier (DOI)