What is the appropriate initial empiric antibiotic therapy for suspected Peritoneal Dialysis related peritonitis?
Initial empiric therapy should reflect knowledge of both the epidemiology of peritonitis and the antibiotic sensitivities in the local PD unit. In general, ISPD recommends initial coverage of both gram-positive and gram-negative microorganisms. Use of a third-generation cephalosporin or an aminoglycoside for gram-negative coverage and vancomycin or a first-generation cephalosporin for gram-positive coverage would accomplish these goals. This should provide coverage against the majority of organisms that cause peritonitis, including Pseudomonas and S. aureus. Initial and subsequent doses of antibiotics for IP administration can be found at www.ISPD.org .