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OBJECTIVES: In this open trial, the efficacy of imipenem/cilastatin was investigated in 88 peritonitis episodes in 50 chronic renal failure patients on continues ambulatory peritoneal dialysis (CAPD) in one year.
METHODS:Biphasic Castenada medium (Blood culture system), blood base agar and Me Conkey media (plate method) were used for microbiological determination. Imipenem/cilastatin was used as the empirical therapy in all patients. One g loading dose of Imipenem/cilastatin IV was given to all patients at the first day. 100 mg Imipenem/cilastatin in 2 liter dialysis solution was administered to all patients as the standard therapy for the following 9 days. Primary response was accepted to occur when PMNL number in the dialysis solution decreased to 100/mm3
RESULTS:Primary response, relapse and overall cure rate were 93%, 4%, 89% respectively in imipenem/cilastatin treatment. Blood culture system (77%) was found to be more sensitive than plate method (43%) in isolating the micro-organisms which were as follows in order of decreasing frequency: Staphylococcus epidermidis (50%), E. Coli (17%), Staphylococcus aureus (13%) and Klebsiella spp. (7%).
CONCLUSION:It can be concluded that Imipenem/cilastatin first-line treatment is highly efficient in CAPD peritonitis.