Evidence-based medicine: An update on treatments for peritoneal dialysis-related peritonitis

Table 1 Recommendations for antibiotics choice in peritoneal dialysis-related peritonitis

	Monitoring the etiologies and antimicrobial resistance profile
	Yes	No
Initial (empirical) protocol	Start intraperitoneal antibiotics to cover gram-positive and gram roads, according to local microbiologic profile	Start a glycopeptide (gram-positive coverage) plus ceftazidime (gram-negative coverage), both by intraperitoneal route1
After results of culture and in vitro susceptibility tests	Culture positive: adjust the treatment according to bacterial susceptibility. If Pseudomonas spp on culture, add a second anti-pseudomonas drug acting in different ways that organism is sensitive to2	Culture positive: adjust the treatment according to bacterial susceptibility. If Pseudomonas spp on culture, add a second anti-pseudomonas drug acting in different ways that organism is sensitive to2
	Culture negative: continue initial antibiotics	Culture negative: Continue initial antibiotics
Therapy duration	Pseudomonas spp, Enterococcus/Streptococcus spp = 21 d
	Non-pseudomonas single gram-negative = 14-21 d
	Culture negative, coagulase negative staphylococcus, other gram-positive roads = 14 d

¹Evidence-based medicine;

²E.g., quinolone, ceftazidime, cefepime, amiglycoside, piperacillin.