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May 1987

Peritonitis in Continuous Ambulatory Peritoneal Dialysis: Making Therapeutic Decisions Easier

Author Affiliations

University of Toronto Toronto Western Hospital 399 Bathurst St Toronto, Ontario, Canada M5T 2S8

Arch Intern Med. 1987;147(5):818-819. doi:10.1001/archinte.1987.00370050014003

In spite of major advances, peritonitis is still the major concern for patients and doctors in continuous ambulatory peritoneal dialysis (CAPD) treatment. Prevention of peritonitis is one of the major goals of those working in the field, yet early and adequate treatment is equally important.

The morbidity and outcome of peritonitis depends on the causative organism; Staphylococcus epidermidis, the most frequent organism, is mild, responding easily to treatment. In contrast, peritonitis due to Staphylococcus aureus or gram-negative organisms can cause severe morbidity and even death.

Gram-negative peritonitis represents approximately 20% of all peritonitis in patients undergoing CAPD. The presence of more than one gram-negative organism indicates a fecal leak and the need for surgical intervention if the patient does not respond within two or three days. If the patient responds but the cultures remain positive, CAPD may have to be discontinued temporarily to give peritoneal defenses a chance to seal

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