An easy outpatient protocol for CAPD peritonitis and its therapeutic value

In order to eliminate the need for hospitalization in the treatment of CAPD peritonitis, we have designed a new outpatient protocol. Twelve episodes of CAPD peritonitis occurring in our hospital during the period from April, 1988, to December, 1989, were treated in accordance with this protocol. On the first day the patients were given intraperitoneal doses of vancomycin (VCM: 30mg/kg body weight) mixed into 2 liters of PD fluid, intramuscular doses of tobramycin (TOB: 120mg) and prescribed daily oral doses of of loxacin (OFLX: 200mg). The patients were subsequently sent home with instructions to drain the fluid after 6 hours in the peritoneal cavity and to resume their previous CAPD schedule. Clinical course was checked by telephone every morning. The patients returned to our hospital on the 7th day and were given both second intraperitoneal doses of VCM and intramuscular doses of TOB in the same manner as on the first day. Nine of the twelve episodes (75%) were successfully treated using this protocol and had no need of hospitalization. Three patients, however, did not respond to this protocol, but healed after their regimen was changed or their catheter was removed. In patients treated successfully using this protocol, dialysate turbidity disappeared within 3.3±1.7 days, and there were only two hospital visits. In conclusion our protocol has proven effective, simple and easy to perform on an outpatient basis and valuable in the treatment of CAPD peritonitis.