{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:37:30Z","timestamp":1792028250522,"version":"4.4.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p>\n                    Peritonitis is a common and severe complication in peritoneal dialysis (PD). Detailed recommendations on the prevention and treatment of PD-associated peritonitis have been published by the International Society for Peritoneal Dialysis (ISPD), but there is a substantial variation in clinical practice among dialysis units. Prophylactic antibiotics administered before PD catheter insertion, colonoscopy, or invasive gynecologic procedures, daily topical application of antibiotic cream or ointment to the catheter exit site, and prompt treatment of exit site or catheter infection are key measures to prevent PD-associated peritonitis. When a patient on PD presents with clinical features compatible with PD-associated peritonitis, empirical antibiotic therapy, with coverage of both Gram-positive and Gram-negative organisms (including\n                    <jats:italic toggle=\"yes\">Pseudomonas<\/jats:italic>\n                    species), should be started once the appropriate microbiologic specimens have been obtained. Intraperitoneal is the preferred route of administration. Antifungal prophylaxis, preferably oral nystatin, should be added to prevent secondary fungal peritonitis. Once the PD effluent Gram stain or culture and sensitivity results are available, antibiotic therapy can be adjusted accordingly. A detailed description on the dosage of individual antibiotic can be found in the latest recommendations by the ISPD. The duration of antibiotics is usually 2\u20133 weeks, depending on the specific organisms identified. Catheter removal and temporary hemodialysis support is recommended for refractory, relapsing, or fungal peritonitis. In some patients, a new PD catheter could be inserted after complete resolution of the peritonitis. PD catheter removal should also be considered for refractory exit site or tunnel infections. After the improvement in clinical practice, there is a worldwide trend of reduction in PD-associated peritonitis rate, supporting the use of PD as a first-line dialysis modality.\n                  <\/jats:p>","DOI":"10.2215\/cjn.14631218","type":"journal-article","created":{"date-parts":[[2019,5,8]],"date-time":"2019-05-08T15:05:35Z","timestamp":1557327935000},"page":"1100-1105","source":"Crossref","is-referenced-by-count":149,"title":["Peritoneal Dialysis\u2013Associated Peritonitis"],"prefix":"10.2215","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8898-8505","authenticated-orcid":false,"given":"Cheuk-Chun","family":"Szeto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip Kam-Tao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,5,8]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1093\/ndt\/gfg027","article-title":"Are peritoneal dialysis patients with and without residual renal function equivalent for survival study? Insight from a retrospective review of the cause of death","volume":"18","author":"Szeto","year":"2003","journal-title":"Nephrol Dial Transplant"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1681\/ASN.2011121135","article-title":"Recent peritonitis associates with mortality among patients treated with peritoneal dialysis","volume":"23","author":"Boudville","year":"2012","journal-title":"J Am Soc Nephrol"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.2215\/CJN.12321216","article-title":"Multicenter registry analysis of center characteristics associated with technique failure in patients on incident peritoneal dialysis","volume":"12","author":"Htay","year":"2017","journal-title":"Clin J Am Soc Nephrol"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"393","DOI":"10.3747\/pdi.2010.00049","article-title":"Peritoneal dialysis-related infections recommendations: 2010 update","volume":"30","author":"Li","year":"2010","journal-title":"Perit Dial Int"},{"key":"B5-20230813","doi-asserted-by":"crossref","first-page":"614","DOI":"10.3747\/pdi.2011.00057","article-title":"ISPD position statement on reducing the risks of peritoneal dialysis-related infections","volume":"31","author":"Piraino","year":"2011","journal-title":"Perit Dial Int"},{"key":"B6-20230813","doi-asserted-by":"crossref","first-page":"481","DOI":"10.3747\/pdi.2016.00078","article-title":"ISPD peritonitis recommendations: 2016 update on prevention and treatment","volume":"36","author":"Li","year":"2016","journal-title":"Perit Dial Int"},{"key":"B7-20230813","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3747\/pdi.2016.00120","article-title":"ISPD catheter-related infection recommendations: 2017 update","volume":"37","author":"Szeto","year":"2017","journal-title":"Perit Dial Int"},{"key":"B8-20230813","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1053\/j.ajkd.2014.02.025","article-title":"Peritoneal dialysis-related peritonitis: Towards improving evidence, practices, and outcomes","volume":"64","author":"Cho","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"B9-20230813","article-title":"Regional variation in the treatment and prevention of peritoneal dialysis-related infections in the Peritoneal Dialysis Outcomes and Practice Patterns Study [published online ahead of print July 23, 2018]","author":"Boudville","journal-title":"Nephrol Dial Transplant"},{"key":"B10-20230813","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/S0272-6386(04)00941-2","article-title":"Antimicrobial agents to prevent peritonitis in peritoneal dialysis: A systematic review of randomized controlled trials","volume":"44","author":"Strippoli","year":"2004","journal-title":"Am J Kidney Dis"},{"key":"B11-20230813","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1097\/01.ASN.0000141463.95561.79","article-title":"Catheter-related interventions to prevent peritonitis in peritoneal dialysis: A systematic review of randomized, controlled trials","volume":"15","author":"Strippoli","year":"2004","journal-title":"J Am Soc Nephrol"},{"key":"B12-20230813","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1038\/ki.2013.365","article-title":"A systematic review and meta-analysis of the influence of peritoneal dialysis catheter type on complication rate and catheter survival","volume":"85","author":"Hagen","year":"2014","journal-title":"Kidney Int"},{"key":"B13-20230813","doi-asserted-by":"crossref","first-page":"2310","DOI":"10.1093\/ndt\/gfq002","article-title":"Relationship between double-cuff versus single-cuff peritoneal dialysis catheters and risk of peritonitis","volume":"25","author":"Nessim","year":"2010","journal-title":"Nephrol Dial Transplant"},{"key":"B14-20230813","first-page":"CD003078","article-title":"Double bag or Y-set versus standard transfer systems for continuous ambulatory peritoneal dialysis in end-stage kidney disease","volume":"8","author":"Daly","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"B15-20230813","doi-asserted-by":"crossref","first-page":"39","DOI":"10.3747\/pdi.2009.00235","article-title":"Similar peritonitis outcome in CAPD and APD patients with dialysis modality continuation during peritonitis","volume":"31","author":"R\u00fcger","year":"2011","journal-title":"Perit Dial Int"},{"key":"B16-20230813","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.2215\/CJN.09730913","article-title":"The association between peritoneal dialysis modality and peritonitis","volume":"9","author":"Lan","year":"2014","journal-title":"Clin J Am Soc Nephrol"},{"key":"B17-20230813","first-page":"CD007554","article-title":"Biocompatible dialysis fluids for peritoneal dialysis","volume":"10","author":"Htay","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"B18-20230813","doi-asserted-by":"crossref","first-page":"592","DOI":"10.3747\/pdi.2015.00277","article-title":"A syllabus for teaching peritoneal dialysis to patients and caregivers","volume":"36","author":"Figueiredo","year":"2016","journal-title":"Perit Dial Int"},{"key":"B19-20230813","first-page":"214","article-title":"Focus on peritoneal dialysis training: Working to decrease peritonitis rates","volume":"31","author":"Zhang","year":"2016","journal-title":"Nephrol Dial Transplant"},{"key":"B21-20230813","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.3109\/0886022X.2014.927771","article-title":"Implementation of a continuous quality improvement program reduces the occurrence of peritonitis in PD","volume":"36","author":"Wang","year":"2014","journal-title":"Ren Fail"},{"key":"B22-20230813","doi-asserted-by":"crossref","first-page":"472","DOI":"10.3747\/pdi.2016.00114","article-title":"Continuous quality improvement initiatives to sustainably reduce peritoneal dialysis-related infections in Australia and New Zealand","volume":"36","author":"Nataatmadja","year":"2016","journal-title":"Perit Dial Int"},{"key":"B23-20230813","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.2215\/CJN.00980112","article-title":"The association between exit site infection and subsequent peritonitis among peritoneal dialysis patients","volume":"7","author":"van Diepen","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"key":"B24-20230813","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1093\/ndt\/gfp411","article-title":"Mupirocin for preventing exit-site infection and peritonitis in patients undergoing peritoneal dialysis","volume":"25","author":"Xu","year":"2010","journal-title":"Nephrol Dial Transplant"},{"key":"B25-20230813","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.ajic.2013.12.008","article-title":"Prevention of gram-positive infections in peritoneal dialysis patients in Hong Kong: A cost-effectiveness analysis","volume":"42","author":"Wong","year":"2014","journal-title":"Am J Infect Control"},{"key":"B26-20230813","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/ndt\/gfp615","article-title":"Mupirocin for preventing exit-site infection and peritonitis in patients undergoing peritoneal dialysis. Was it effective?","volume":"25","author":"Piraino","year":"2010","journal-title":"Nephrol Dial Transplant"},{"key":"B27-20230813","first-page":"15","article-title":"Erosion of the silicone peritoneal dialysis catheter with the use of gentamicin cream at the exit site","volume":"32","author":"Gardezi","year":"2016","journal-title":"Adv Perit Dial"},{"key":"B28-20230813","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1681\/ASN.2004090773","article-title":"Randomized, double-blind trial of antibiotic exit site cream for prevention of exit site infection in peritoneal dialysis patients","volume":"16","author":"Bernardini","year":"2005","journal-title":"J Am Soc Nephrol"},{"key":"B29-20230813","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/S1473-3099(13)70258-5","article-title":"Antibacterial honey for the prevention of peritoneal-dialysis-related infections (HONEYPOT): A randomised trial","volume":"14","author":"Johnson","year":"2014","journal-title":"Lancet Infect Dis"},{"key":"B30-20230813","doi-asserted-by":"crossref","first-page":"297","DOI":"10.2215\/CJN.07970811","article-title":"A randomized controlled trial comparing mupirocin and polysporin triple ointments in peritoneal dialysis patients: The MP3 study","volume":"7","author":"McQuillan","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"key":"B31-20230813","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/S0272-6386(96)90105-5","article-title":"A randomized trial of Staphylococcus aureus prophylaxis in peritoneal dialysis patients: Mupirocin calcium ointment 2% applied to the exit site versus cyclic oral rifampin","volume":"27","author":"Bernardini","year":"1996","journal-title":"Am J Kidney Dis"},{"key":"B33-20230813","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/S0163-4453(03)00119-1","article-title":"Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis: A single centre Indian experience","volume":"48","author":"Prasad","year":"2004","journal-title":"J Infect"},{"key":"B34-20230813","first-page":"CD005284","article-title":"Treatment for peritoneal dialysis-associated peritonitis","volume":"26","author":"Ballinger","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"B35-20230813","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ekir.2016.05.003","article-title":"The relationship between presentation and the time of initial administration of antibiotics with outcomes of peritonitis in peritoneal dialysis patients: The PROMPT study","volume":"1","author":"Muthucumarana","year":"2016","journal-title":"Kidney Int Rep"},{"key":"B36-20230813","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/089686080902900101","article-title":"Intraperitoneal administration of drugs in peritoneal dialysis patients: A review of compatibility and guidance for clinical use","volume":"29","author":"de Vin","year":"2009","journal-title":"Perit Dial Int"},{"key":"B37-20230813","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.2215\/CJN.00630117","article-title":"Residual kidney function and peritoneal dialysis-associated peritonitis treatment outcomes","volume":"12","author":"Whitty","year":"2017","journal-title":"Clin J Am Soc Nephrol"},{"key":"B38-20230813","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1093\/ndt\/gfm079","article-title":"Single UK centre experience on the treatment of PD peritonitis--antibiotic levels and outcomes","volume":"22","author":"Blunden","year":"2007","journal-title":"Nephrol Dial Transplant"},{"key":"B39-20230813","doi-asserted-by":"crossref","first-page":"180","DOI":"10.3747\/pdi.2013.00075","article-title":"Predictors of residual renal function decline in patients undergoing continuous ambulatory peritoneal dialysis","volume":"35","author":"Szeto","year":"2015","journal-title":"Perit Dial Int"},{"key":"B40-20230813","doi-asserted-by":"crossref","first-page":"179","DOI":"10.3109\/08860220903491224","article-title":"Correlation between hearing loss and peritonitis frequency and administration of ototoxic intraperitoneal antibiotics in patients with CAPD","volume":"32","author":"Tokgoz","year":"2010","journal-title":"Ren Fail"},{"key":"B41-20230813","doi-asserted-by":"crossref","first-page":"768","DOI":"10.2215\/CJN.01010306","article-title":"Predictive value of dialysate cell counts in peritonitis complicating peritoneal dialysis","volume":"1","author":"Chow","year":"2006","journal-title":"Clin J Am Soc Nephrol"},{"key":"B42-20230813","doi-asserted-by":"crossref","first-page":"4073","DOI":"10.1093\/ndt\/gfr211","article-title":"Protective effect of N-acetylcysteine from drug-induced ototoxicity in uraemic patients with CAPD peritonitis","volume":"26","author":"Tokgoz","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"B43-20230813","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1007\/s10096-015-2477-8","article-title":"The influence of different peritoneal dialysis fluids on the in vitro activity of ampicillin, daptomycin, and linezolid against Enterococcus faecalis","volume":"34","author":"Kussmann","year":"2015","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"B44-20230813","doi-asserted-by":"crossref","first-page":"2309","DOI":"10.1046\/j.1523-1755.2001.00748.x","article-title":"Clinical course of peritonitis due to Pseudomonas species complicating peritoneal dialysis: A review of 104 cases","volume":"59","author":"Szeto","year":"2001","journal-title":"Kidney Int"},{"key":"B45-20230813","doi-asserted-by":"crossref","first-page":"957","DOI":"10.2215\/CJN.00010109","article-title":"Pseudomonas peritonitis in Australia: Predictors, treatment, and outcomes in 191 cases","volume":"4","author":"Siva","year":"2009","journal-title":"Clin J Am Soc Nephrol"},{"key":"B46-20230813","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/S0002-9343(02)01364-5","article-title":"Conservative management of polymicrobial peritonitis complicating peritoneal dialysis--a series of 140 consecutive cases","volume":"113","author":"Szeto","year":"2002","journal-title":"Am J Med"},{"key":"B47-20230813","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1681\/ASN.V1341040","article-title":"Feasibility of resuming peritoneal dialysis after severe peritonitis and Tenckhoff catheter removal","volume":"13","author":"Szeto","year":"2002","journal-title":"J Am Soc Nephrol"},{"key":"B48-20230813","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s40620-014-0048-1","article-title":"Reinitiation of peritoneal dialysis after catheter removal for refractory peritonitis","volume":"27","author":"Ram","year":"2014","journal-title":"J Nephrol"},{"key":"B49-20230813","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.semnephrol.2016.10.002","article-title":"Current challenges and opportunities in PD","volume":"37","author":"Li","year":"2017","journal-title":"Semin Nephrol"},{"key":"B50-20230813","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1038\/nrneph.2016.181","article-title":"Changes in the worldwide epidemiology of peritoneal dialysis","volume":"13","author":"Li","year":"2017","journal-title":"Nat Rev Nephrol"}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01277230-201907000-00026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:40:46Z","timestamp":1786369246000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01277230-201907000-00026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,8]]},"references-count":48,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.14631218","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,8]]}}}