Oral ciprofloxacin in the treatment of peritonitis in patients on continuous ambulatory peritoneal dialysis

Oral ciprofloxacin in doses of 0·75 to 2g daily for 8–16 (median 10) days was given as first-line treatment of 33 unselected episodes of CAPD-associated peritonitis in 20 patients. Treatment was well tolerated and effective, curing 25 episodes. Treatment was withdrawn in five episodes, four because of resistant organisms and in the other because of vomiting. Infection relapsed twice in one patient during follow-up and one patient had persistence of the infecting organism (Pseudomonas aeruginosa) despite clinical improvement. Plasma and dialysate ciprofloxacin levels ranged from 1 to 8 mg/l. Assay between days 2 and 4 of treatment indicated the ciprofloxacin steady state concentration. If this proves to be > 7 mg/l the dose may be reduced and if < 2 mg/l the dose should be increased. Overall a single course of oral ciprofloxacin was 76% successful as a first-line treatment for CAPD-associated peritonitis, caused by a wide range of organisms.