STAPHYLOCOCCUS AUREUS PERITONITIS IN AUSTRALIAN PERITONEAL DIALYSIS PATIENTS: PREDICTORS, TREATMENT, AND OUTCOMES IN 503 CASES -- Govindarajulu et al. 30 (3): 311 -- Peritoneal Dialysis International.
Staphylococcus aureus peritonitis is a serious complication of peritoneal dialysis (PD). The predominant antibiotics used as initial empiric therapy were vancomycin (61%) and cephazolin (31%). The initial empiric antibiotic choice between vancomycin and cephazolin was not significantly associated with clinical outcomes, but serious adverse outcomes were more likely if vancomycin was not used for subsequent treatment of MRSA peritonitis. In conclusion, S. aureus peritonitis is a serious complication of PD, involves a small proportion of patients, and is associated with a high rate of relapse and repeat episodes. Other adverse clinical outcomes are similar to those for peritonitis overall but are significantly worse for MRSA peritonitis. Empiric initial therapy with either vancomycin or cephazolin results in comparable outcomes, provided vancomycin is prescribed when MRSA is isolated and identified.
