Relapsing Peritonitis in Continuous Ambulatory Peritoneal Dialysis (CAPD): Treatment by Interruption of CAPO and Prolonged Antibiotic Therapy

Relapsing peritonitis was assessed in the continuous ambulatory peritoneal dialysis (CAPD) population of a large, outpatient dialysis facility. Prolonged systemic treatment with antibiotics often fails, resulting in the eventual removal and subsequent reimplantation of the catheter. We have tried a new approach to avoid removal of the peritoneal catheter. Patients were treated by the interruption of CAPD, conversion to hemodialysis or discontinuation of dialysis for a period of 7 to 21 days while continuing systemic antibiotics. Over a period of 76.63 patient years, 69 episodes of bacterial peritonitis occurred (0.9 episodes per patient year). Of these, five episodes could be classified as relapsing peritonitis. Five patients with gram-positive relapsing peritonitis were treated by this regimen; all responded with a cure. Our results suggest that relapsing peritonitis can be eradicated without the removal of the peritoneal catheter.