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Discussion:Arlon/04-0564551

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      <fA01 i1="01" i2="1">
        <s0>0896-8608</s0>
      </fA01>
      <fA03 i2="1">
        <s0>Perit. dial. int.</s0>
      </fA03>
      <fA05>
        <s2>24</s2>
      </fA05>
      <fA06>
        <s2>5</s2>
      </fA06>
      <fA08 i1="01" i2="1" l="ENG">
        <s1>Vancomycin and ciprofloxacin: Systemic antibiotic administration for peritoneal dialysis-associated peritonitis</s1>
      </fA08>
      <fA11 i1="01" i2="1">
        <s1>GOFFIN (Eric)</s1>
      </fA11>
      <fA11 i1="02" i2="1">
        <s1>HERBIET (Lawrence)</s1>
      </fA11>
      <fA11 i1="03" i2="1">
        <s1>POUTHIER (Dominique)</s1>
      </fA11>
      <fA11 i1="04" i2="1">
        <s1>POCHET (Jean-Michel)</s1>
      </fA11>
      <fA11 i1="05" i2="1">
        <s1>LAFONTAINE (Jean-Jacques)</s1>
      </fA11>
      <fA11 i1="06" i2="1">
        <s1>CHRISTOPHE (Jean-Louis)</s1>
      </fA11>
      <fA11 i1="07" i2="1">
        <s1>GIGI (Jacques)</s1>
      </fA11>
      <fA11 i1="08" i2="1">
        <s1>VANDERCAM (Bernard)</s1>
      </fA11>
      <fA14 i1="01">
        <s1>Department of Nephrology, Cliniques Universitaires St. Luc, Université Catholique de Louvain</s1>
        <s2>Brussels</s2>
        <s3>BEL</s3>
        <sZ>1 aut.</sZ>
        <sZ>2 aut.</sZ>
      </fA14>
      <fA14 i1="02">
        <s1>Department of Nephrology, Centre Hospitalier</s1>
        <s3>LUX</s3>
        <sZ>3 aut.</sZ>
      </fA14>
      <fA14 i1="03">
        <s1>Clinique Ste. Elisabeth</s1>
        <s2>Namur</s2>
        <s3>BEL</s3>
        <sZ>4 aut.</sZ>
      </fA14>
      <fA14 i1="04">
        <s1>Hôpital St. Joseph</s1>
        <s2>Arlon</s2>
        <s3>BEL</s3>
        <sZ>5 aut.</sZ>
      </fA14>
      <fA14 i1="05">
        <s1>Hôpital St. Joseph</s1>
        <s2>Gilly</s2>
        <s3>BEL</s3>
        <sZ>6 aut.</sZ>
      </fA14>
      <fA14 i1="06">
        <s1>Department of Microbiology, Cliniques Universitaires St. Luc, Université Catholique de Louvain</s1>
        <s2>Brussels</s2>
        <s3>BEL</s3>
        <sZ>7 aut.</sZ>
      </fA14>
      <fA14 i1="07">
        <s1>Department of Internal Medicine, Cliniques Universitaires St. Luc, Université Catholique de Louvain</s1>
        <s2>Brussels</s2>
        <s3>BEL</s3>
        <sZ>8 aut.</sZ>
      </fA14>
      <fA20>
        <s1>433-439</s1>
      </fA20>
      <fA21>
        <s1>2004</s1>
      </fA21>
      <fA23 i1="01">
        <s0>ENG</s0>
      </fA23>
      <fA43 i1="01">
        <s1>INIST</s1>
        <s2>21280</s2>
        <s5>354000122361140020</s5>
      </fA43>
      <fA44>
        <s0>0000</s0>
        <s1>© 2004 INIST-CNRS. All rights reserved.</s1>
      </fA44>
      <fA45>
        <s0>35 ref.</s0>
      </fA45>
      <fA47 i1="01" i2="1">
        <s0>04-0564551</s0>
      </fA47>
      <fA60>
        <s1>P</s1>
      </fA60>
      <fA61>
        <s0>A</s0>
      </fA61>
      <fA64 i1="01" i2="1">
        <s0>Peritoneal dialysis international</s0>
      </fA64>
      <fA66 i1="01">
        <s0>CAN</s0>
      </fA66>
      <fC01 i1="01" l="ENG">
        <s0>✦ Objectives: Peritonitis due to peritoneal dialysis (PD) is best treated empirically while waiting for the results of the dialysate culture. Thus, antibiotic therapy must cover both gram-positive and gram-negative micro-organisms. First, over a period of 9 years in a multicenter study we evaluated the efficiency of a vancomycin and ciprofloxacin combination given as the first-line treatment protocol for PD peritonitis. Second, we evaluated whether a systemic route of administration of the antibiotics could be an interesting alternative to the usual cumbersome intraperitoneal drug administration. ✦ Methods: Vancomycin 15 mg/kg body weight, intravenous, and oral ciprofloxacin 250 mg two times per day (500 mg twice per day if residual creatinine clearance was above 3 mUminute) were prescribed at diagnosis of peritonitis. Vancomycin injections were repeated (when blood trough level was expected to be below 12 μg/mL) in cases of gram-positive organisms for a total duration of 3 weeks. Ciprofloxacin was given for a total of 3 weeks in cases of gram-negative and a total of 10 days for susceptible gram-positive infections. ✦ Results: A total of 129 episodes of peritonitis occurred; 28 of them were not included in the study because of protocol violation (n = 15) or fungal (n = 7) or fecal (n = 6) peritonitis, leaving 101 peritonitis episodes for analysis. 52 (51.5%) gram-positive and 28 (27.7%) gram-negative organisms were grown; 38 gram-positive organisms were coagulase-negative staphylococci. No organism was identified in 8 peritonitis episodes, whereas 13 peritonitis episodes were caused by more than 1 organism. 35% of the coagulase-negative staphylococci were resistant to first-generation cephalosporin and methicillin, whereas all were susceptible to vancomycin. For gram-negative bacilli, the susceptibility rate was 96% and 95% for ciprofloxacin and ceftazidime respectively. The overall treatment success rate was 77.2% (78 of the 101 peritonitis episodes): 61.4% at first intention and 15.8% after optimization of the antibiotic therapy (second intention). The protocol failed in 22.8% of the peritonitis episodes. Hospitalization was required in 52% of the peritonitis episodes; average hospitalization was 11 (range 1- 45) days. ✦ Conclusion: Systemic vancomycin and ciprofloxacin administration is a simple and efficient first-line protocol antibiotic therapy for PD peritonitis. In our opinion, vancomycin should still be used for gram-positive infections because of its high susceptibility rate compared with first-generation cephalosporins, providing a close monitoring of the local epidemiology. Oral ciprofloxacin provides satisfactory results in gram-negative infections, comparable to those obtained with intraperitoneal ceftazidime or aminoglycosides.</s0>
      </fC01>
      <fC02 i1="01" i2="X">
        <s0>002B27B03</s0>
      </fC02>
      <fC02 i1="02" i2="X">
        <s0>002B25H</s0>
      </fC02>
      <fC02 i1="03" i2="X">
        <s0>002B14A01</s0>
      </fC02>
      <fC03 i1="01" i2="X" l="FRE">
        <s0>Insuffisance rénale</s0>
        <s5>01</s5>
      </fC03>
      <fC03 i1="01" i2="X" l="ENG">
        <s0>Renal failure</s0>
        <s5>01</s5>
      </fC03>
      <fC03 i1="01" i2="X" l="SPA">
        <s0>Insuficiencia renal</s0>
        <s5>01</s5>
      </fC03>
      <fC03 i1="02" i2="X" l="FRE">
        <s0>Dialyse péritonéale</s0>
        <s5>02</s5>
      </fC03>
      <fC03 i1="02" i2="X" l="ENG">
        <s0>Peritoneal dialysis</s0>
        <s5>02</s5>
      </fC03>
      <fC03 i1="02" i2="X" l="SPA">
        <s0>Diálisis peritoneal</s0>
        <s5>02</s5>
      </fC03>
      <fC03 i1="03" i2="X" l="FRE">
        <s0>Epuration extrarénale</s0>
        <s5>03</s5>
      </fC03>
      <fC03 i1="03" i2="X" l="ENG">
        <s0>Extrarenal dialysis</s0>
        <s5>03</s5>
      </fC03>
      <fC03 i1="03" i2="X" l="SPA">
        <s0>Depuración extrarrenal</s0>
        <s5>03</s5>
      </fC03>
      <fC03 i1="04" i2="X" l="FRE">
        <s0>Péritonite</s0>
        <s5>04</s5>
      </fC03>
      <fC03 i1="04" i2="X" l="ENG">
        <s0>Peritonitis</s0>
        <s5>04</s5>
      </fC03>
      <fC03 i1="04" i2="X" l="SPA">
        <s0>Peritonitis</s0>
        <s5>04</s5>
      </fC03>
      <fC03 i1="05" i2="X" l="FRE">
        <s0>Vancomycine</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>05</s5>
      </fC03>
      <fC03 i1="05" i2="X" l="ENG">
        <s0>Vancomycin</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>05</s5>
      </fC03>
      <fC03 i1="05" i2="X" l="SPA">
        <s0>Vancomicina</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>05</s5>
      </fC03>
      <fC03 i1="06" i2="X" l="FRE">
        <s0>Ciprofloxacine</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>06</s5>
      </fC03>
      <fC03 i1="06" i2="X" l="ENG">
        <s0>Ciprofloxacin</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>06</s5>
      </fC03>
      <fC03 i1="06" i2="X" l="SPA">
        <s0>Ciprofloxacino</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>06</s5>
      </fC03>
      <fC03 i1="07" i2="X" l="FRE">
        <s0>Antibiotique</s0>
        <s5>08</s5>
      </fC03>
      <fC03 i1="07" i2="X" l="ENG">
        <s0>Antibiotic</s0>
        <s5>08</s5>
      </fC03>
      <fC03 i1="07" i2="X" l="SPA">
        <s0>Antibiótico</s0>
        <s5>08</s5>
      </fC03>
      <fC03 i1="08" i2="X" l="FRE">
        <s0>Staphylococcus aureus</s0>
        <s2>NS</s2>
        <s5>09</s5>
      </fC03>
      <fC03 i1="08" i2="X" l="ENG">
        <s0>Staphylococcus aureus</s0>
        <s2>NS</s2>
        <s5>09</s5>
      </fC03>
      <fC03 i1="08" i2="X" l="SPA">
        <s0>Staphylococcus aureus</s0>
        <s2>NS</s2>
        <s5>09</s5>
      </fC03>
      <fC03 i1="09" i2="X" l="FRE">
        <s0>Rifampicine</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>11</s5>
      </fC03>
      <fC03 i1="09" i2="X" l="ENG">
        <s0>Rifampicin</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>11</s5>
      </fC03>
      <fC03 i1="09" i2="X" l="SPA">
        <s0>Rifampicina</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>11</s5>
      </fC03>
      <fC03 i1="10" i2="X" l="FRE">
        <s0>Mupirocine</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>12</s5>
      </fC03>
      <fC03 i1="10" i2="X" l="ENG">
        <s0>Mupirocin</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>12</s5>
      </fC03>
      <fC03 i1="10" i2="X" l="SPA">
        <s0>Mupirocina</s0>
        <s2>NK</s2>
        <s2>FR</s2>
        <s5>12</s5>
      </fC03>
      <fC03 i1="11" i2="X" l="FRE">
        <s0>Antibactérien</s0>
        <s5>25</s5>
      </fC03>
      <fC03 i1="11" i2="X" l="ENG">
        <s0>Antibacterial agent</s0>
        <s5>25</s5>
      </fC03>
      <fC03 i1="11" i2="X" l="SPA">
        <s0>Antibacteriano</s0>
        <s5>25</s5>
      </fC03>
      <fC03 i1="12" i2="X" l="FRE">
        <s0>Antituberculeux</s0>
        <s5>26</s5>
      </fC03>
      <fC03 i1="12" i2="X" l="ENG">
        <s0>Antituberculous agent</s0>
        <s5>26</s5>
      </fC03>
      <fC03 i1="12" i2="X" l="SPA">
        <s0>Antituberculoso</s0>
        <s5>26</s5>
      </fC03>
      <fC07 i1="01" i2="X" l="FRE">
        <s0>Micrococcaceae</s0>
        <s2>NS</s2>
      </fC07>
      <fC07 i1="01" i2="X" l="ENG">
        <s0>Micrococcaceae</s0>
        <s2>NS</s2>
      </fC07>
      <fC07 i1="01" i2="X" l="SPA">
        <s0>Micrococcaceae</s0>
        <s2>NS</s2>
      </fC07>
      <fC07 i1="02" i2="X" l="FRE">
        <s0>Micrococcales</s0>
        <s2>NS</s2>
      </fC07>
      <fC07 i1="02" i2="X" l="ENG">
        <s0>Micrococcales</s0>
        <s2>NS</s2>
      </fC07>
      <fC07 i1="02" i2="X" l="SPA">
        <s0>Micrococcales</s0>
        <s2>NS</s2>
      </fC07>
      <fC07 i1="03" i2="X" l="FRE">
        <s0>Bactérie</s0>
      </fC07>
      <fC07 i1="03" i2="X" l="ENG">
        <s0>Bacteria</s0>
      </fC07>
      <fC07 i1="03" i2="X" l="SPA">
        <s0>Bacteria</s0>
      </fC07>
      <fC07 i1="04" i2="X" l="FRE">
        <s0>Appareil urinaire pathologie</s0>
        <s5>37</s5>
      </fC07>
      <fC07 i1="04" i2="X" l="ENG">
        <s0>Urinary system disease</s0>
        <s5>37</s5>
      </fC07>
      <fC07 i1="04" i2="X" l="SPA">
        <s0>Aparato urinario patología</s0>
        <s5>37</s5>
      </fC07>
      <fC07 i1="05" i2="X" l="FRE">
        <s0>Rein pathologie</s0>
        <s5>38</s5>
      </fC07>
      <fC07 i1="05" i2="X" l="ENG">
        <s0>Kidney disease</s0>
        <s5>38</s5>
      </fC07>
      <fC07 i1="05" i2="X" l="SPA">
        <s0>Riñón patología</s0>
        <s5>38</s5>
      </fC07>
      <fC07 i1="06" i2="X" l="FRE">
        <s0>Glycopeptide</s0>
        <s5>39</s5>
      </fC07>
      <fC07 i1="06" i2="X" l="ENG">
        <s0>Glycopeptide</s0>
        <s5>39</s5>
      </fC07>
      <fC07 i1="06" i2="X" l="SPA">
        <s0>Glicopéptido</s0>
        <s5>39</s5>
      </fC07>
      <fC07 i1="07" i2="X" l="FRE">
        <s0>Peptide</s0>
        <s5>40</s5>
      </fC07>
      <fC07 i1="07" i2="X" l="ENG">
        <s0>Peptides</s0>
        <s5>40</s5>
      </fC07>
      <fC07 i1="07" i2="X" l="SPA">
        <s0>Péptido</s0>
        <s5>40</s5>
      </fC07>
      <fC07 i1="08" i2="X" l="FRE">
        <s0>Polypeptide</s0>
        <s5>41</s5>
      </fC07>
      <fC07 i1="08" i2="X" l="ENG">
        <s0>Polypeptide</s0>
        <s5>41</s5>
      </fC07>
      <fC07 i1="08" i2="X" l="SPA">
        <s0>Polipéptido</s0>
        <s5>41</s5>
      </fC07>
      <fC07 i1="09" i2="X" l="FRE">
        <s0>Fluoroquinolone dérivé</s0>
        <s5>42</s5>
      </fC07>
      <fC07 i1="09" i2="X" l="ENG">
        <s0>Fluoroquinolone derivatives</s0>
        <s5>42</s5>
      </fC07>
      <fC07 i1="09" i2="X" l="SPA">
        <s0>Fluoroquinolone derivado</s0>
        <s5>42</s5>
      </fC07>
      <fC07 i1="10" i2="X" l="FRE">
        <s0>Quinolone dérivé</s0>
        <s5>43</s5>
      </fC07>
      <fC07 i1="10" i2="X" l="ENG">
        <s0>Quinolone derivatives</s0>
        <s5>43</s5>
      </fC07>
      <fC07 i1="10" i2="X" l="SPA">
        <s0>Quinolone derivado</s0>
        <s5>43</s5>
      </fC07>
      <fC07 i1="11" i2="X" l="FRE">
        <s0>Abdomen pathologie</s0>
        <s5>45</s5>
      </fC07>
      <fC07 i1="11" i2="X" l="ENG">
        <s0>Abdominal disease</s0>
        <s5>45</s5>
      </fC07>
      <fC07 i1="11" i2="X" l="SPA">
        <s0>Abdomen patología</s0>
        <s5>45</s5>
      </fC07>
      <fN21>
        <s1>320</s1>
      </fN21>
      <fN44 i1="01">
        <s1>OTO</s1>
      </fN44>
      <fN82>
        <s1>OTO</s1>
      </fN82>
    </pA>
  </inist>
  <server>
    <NO>: PASCAL 04-0564551 INIST</NO>
    <ET>Vancomycin and ciprofloxacin: Systemic antibiotic administration for peritoneal dialysis-associated peritonitis</ET>
    <AU>GOFFIN (Eric); HERBIET (Lawrence); POUTHIER (Dominique); POCHET (Jean-Michel); LAFONTAINE (Jean-Jacques); CHRISTOPHE (Jean-Louis); GIGI (Jacques); VANDERCAM (Bernard)</AU>
    <AF>Department of Nephrology, Cliniques Universitaires St. Luc, Université Catholique de Louvain/Brussels/Belgique (1 aut., 2 aut.); Department of Nephrology, Centre Hospitalier/Luxembourg (3 aut.); Clinique Ste. Elisabeth/Namur/Belgique (4 aut.); Hôpital St. Joseph/Arlon/Belgique (5 aut.); Hôpital St. Joseph/Gilly/Belgique (6 aut.); Department of Microbiology, Cliniques Universitaires St. Luc, Université Catholique de Louvain/Brussels/Belgique (7 aut.); Department of Internal Medicine, Cliniques Universitaires St. Luc, Université Catholique de Louvain/Brussels/Belgique (8 aut.)</AF>
    <DT>Publication en série; Niveau analytique</DT>
    <SO>Peritoneal dialysis international; ISSN 0896-8608; Canada; Da. 2004; Vol. 24; No. 5; Pp. 433-439; Bibl. 35 ref.</SO>
    <LA>Anglais</LA>
    <EA>✦ Objectives: Peritonitis due to peritoneal dialysis (PD) is best treated empirically while waiting for the results of the dialysate culture. Thus, antibiotic therapy must cover both gram-positive and gram-negative micro-organisms. First, over a period of 9 years in a multicenter study we evaluated the efficiency of a vancomycin and ciprofloxacin combination given as the first-line treatment protocol for PD peritonitis. Second, we evaluated whether a systemic route of administration of the antibiotics could be an interesting alternative to the usual cumbersome intraperitoneal drug administration. ✦ Methods: Vancomycin 15 mg/kg body weight, intravenous, and oral ciprofloxacin 250 mg two times per day (500 mg twice per day if residual creatinine clearance was above 3 mUminute) were prescribed at diagnosis of peritonitis. Vancomycin injections were repeated (when blood trough level was expected to be below 12 μg/mL) in cases of gram-positive organisms for a total duration of 3 weeks. Ciprofloxacin was given for a total of 3 weeks in cases of gram-negative and a total of 10 days for susceptible gram-positive infections. ✦ Results: A total of 129 episodes of peritonitis occurred; 28 of them were not included in the study because of protocol violation (n = 15) or fungal (n = 7) or fecal (n = 6) peritonitis, leaving 101 peritonitis episodes for analysis. 52 (51.5%) gram-positive and 28 (27.7%) gram-negative organisms were grown; 38 gram-positive organisms were coagulase-negative staphylococci. No organism was identified in 8 peritonitis episodes, whereas 13 peritonitis episodes were caused by more than 1 organism. 35% of the coagulase-negative staphylococci were resistant to first-generation cephalosporin and methicillin, whereas all were susceptible to vancomycin. For gram-negative bacilli, the susceptibility rate was 96% and 95% for ciprofloxacin and ceftazidime respectively. The overall treatment success rate was 77.2% (78 of the 101 peritonitis episodes): 61.4% at first intention and 15.8% after optimization of the antibiotic therapy (second intention). The protocol failed in 22.8% of the peritonitis episodes. Hospitalization was required in 52% of the peritonitis episodes; average hospitalization was 11 (range 1- 45) days. ✦ Conclusion: Systemic vancomycin and ciprofloxacin administration is a simple and efficient first-line protocol antibiotic therapy for PD peritonitis. In our opinion, vancomycin should still be used for gram-positive infections because of its high susceptibility rate compared with first-generation cephalosporins, providing a close monitoring of the local epidemiology. Oral ciprofloxacin provides satisfactory results in gram-negative infections, comparable to those obtained with intraperitoneal ceftazidime or aminoglycosides.</EA>
    <CC>002B27B03; 002B25H; 002B14A01</CC>
    <FD>Insuffisance rénale; Dialyse péritonéale; Epuration extrarénale; Péritonite; Vancomycine; Ciprofloxacine; Antibiotique; Staphylococcus aureus; Rifampicine; Mupirocine; Antibactérien; Antituberculeux</FD>
    <FG>Micrococcaceae; Micrococcales; Bactérie; Appareil urinaire pathologie; Rein pathologie; Glycopeptide; Peptide; Polypeptide; Fluoroquinolone dérivé; Quinolone dérivé; Abdomen pathologie</FG>
    <ED>Renal failure; Peritoneal dialysis; Extrarenal dialysis; Peritonitis; Vancomycin; Ciprofloxacin; Antibiotic; Staphylococcus aureus; Rifampicin; Mupirocin; Antibacterial agent; Antituberculous agent</ED>
    <EG>Micrococcaceae; Micrococcales; Bacteria; Urinary system disease; Kidney disease; Glycopeptide; Peptides; Polypeptide; Fluoroquinolone derivatives; Quinolone derivatives; Abdominal disease</EG>
    <SD>Insuficiencia renal; Diálisis peritoneal; Depuración extrarrenal; Peritonitis; Vancomicina; Ciprofloxacino; Antibiótico; Staphylococcus aureus; Rifampicina; Mupirocina; Antibacteriano; Antituberculoso</SD>
    <LO>INIST-21280.354000122361140020</LO>
    <ID>04-0564551</ID>
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</record>