The Efficacy of Prolonged Antibiotic Therapy for the Prevention of Relapsing Peritonitis in Peritoneal Dialysis Patients With High Dialysis Effluent Bacterial DNA Fragment Levels

2015-11-02 16:23:24 | BioPortfolio


Peritoneal dialysis (PD) is the first-line treatment of end stage renal disease (ESRD) in Hong Kong. Despite the advances in antibiotic therapy and connecting system, recurrent peritonitis remains the major cause of peritoneal failure. A recent study showed that an elevated bacterial DNA fragment levels in PD effluent 5 days prior to the completion of antibiotics predicts the development of relapsing or recurrent peritonitis episodes. The investigators hypothesize that prolonged antibiotic therapy in PD patients with peritonitis and high PD effluent bacterial DNA fragment levels could prevent the development of relapsing and recurrent peritonitis. The investigators plan to conduct a randomized control study of 360 patients with PD peritonitis. After inform consent, specimens of PD effluent will be collected 5 days prior to the completion of antibiotics for the measurement of bacterial DNA fragments. Around 120 patients would have their PD effluent bacterial DNA fragment levels above 2 copies per ml. They will be randomized to receive one additional week of the effective antibiotic treatment (the Preemptive Treatment Group) or no additional treatment (the Control Group). All patients will be followed for 6 months after completion of antibiotic therapy for the development of relapsing, recurrent, or repeat peritonitis episodes. Our study will determine the efficacy of a test-before-treat algorithm that could reduce the incidence of relapsing and recurrent peritonitis and, at the same time, minimize the unnecessary use of prolonged antibiotic treatment.

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention


Peritoneal Dialysis


Extended antibiotics (cefazolin or ceftazidime), Usual antibiotics (cefazolin or ceftazidime)


Department of Medicine & Therapeutics, Prince of Wales Hospital
Hong Kong


Not yet recruiting


Chinese University of Hong Kong

Results (where available)

View Results


Published on BioPortfolio: 2015-11-02T16:23:24-0500

Clinical Trials [1595 Associated Clinical Trials listed on BioPortfolio]

Nebulized Ceftazidime and Amikacin in Ventilator Associated Pneumonia

Pseudomonas aeruginosa is one of the major causative microorganisms of ventilator-associated pneumonia often resistant to antibiotics. In experimental models, nebulization of antibiotics d...

A Randomized Double Blinded Comparison of Ceftazidime and Meropenem in Severe Melioidosis

Melioidosis, an infection caused by the bacterium Burkholderia pseudomallei, is a major cause of community-acquired septicaemia in northeast Thailand. Common manifestations include cavitat...

Oral Moxifloxacin Versus Cefazolin and Oral Probenecid in the Management of Skin and Soft Tissue Infections in the Emergency Department

Patients often come to the emergency department with bacterial skin infections (known as "cellulitis"). Some patients with very severe infections are admitted to hospital for antibiotic ...

Adverse Drug Reactions of Different Brands of Ceftazidime Injection

The purpose of this study is to understand whether generic ceftazidime causes different adverse drug reaction incidence from the brand drug.

P.Acnes Colony Count Following Subdermal Cefazolin

The specific outcome is to determine whether the colony count of Propionibacterium acnes, one of the commonest causes of shoulder infection and not eradicated by conventional forms of surg...

PubMed Articles [3692 Associated PubMed Articles listed on BioPortfolio]

Stability and Sterility of Extemporaneously Prepared Nonpreserved Cefazolin, Ceftazidime, Vancomycin, Amphotericin B, and Methylprednisolone Eye Drops.

To determine in-use stability and sterility of fortified cefazolin, ceftazidime, vancomycin, amphotericin B, and methylprednisolone eye drops in a simulated inpatient setting with and without a mobile...

Pharmacokinetic and Pharmacodynamic Analysis of Ceftazidime/Avibactam in Critically Ill Patients.

The pharmacokinetics, especially the volume of distribution (Vd), of ß-lactam antibiotics can be altered in critically ill patients. This can lead to decreased serum concentrations and a reduction in...

Ceftazidime/avibactam resistance associated with L169P mutation in the omega loop of KPC-2.

Ceftazidime/avibactam resistance due to mutation in the omega loop of KPC-2 has been documented in vitro and in vivo. This study evaluated the mechanism of ceftazidime/avibactam resistance in a KPC-2-...

Successful treatment of peritoneal dialysis-related peritonitis caused by Dermacoccus nishinomiyaensis.

A 53-year-old man receiving peritoneal dialysis (PD) for 4 months presented with PD-related peritonitis (abdominal pain, turbid peritoneal dialysate effluent, white blood cell in peritoneal dialysate...

Cefazolin versus anti-staphylococcal penicillins for the treatment of patients with Staphylococcus aureus bacteremia: a systematic review and meta-analysis.

For patients with bacteremia caused by methicillin-sensitive Staphylococcus aureus anti-staphylococcal penicillins (ASP) or cefazolin are agents of choice. While ASPs are potentially nephrotoxic, cefa...

Medical and Biotech [MESH] Definitions

Nonsusceptibility of bacteria to the action of the beta-lactam antibiotics. Mechanisms responsible for beta-lactam resistance may be degradation of antibiotics by BETA-LACTAMASES, failure of antibiotics to penetrate, or low-affinity binding of antibiotics to targets.

Semisynthetic, broad-spectrum antibacterial derived from CEPHALORIDINE and used especially for Pseudomonas and other gram-negative infections in debilitated patients.

A semisynthetic cephalosporin analog with broad-spectrum antibiotic action due to inhibition of bacterial cell wall synthesis. It attains high serum levels and is excreted quickly via the urine.

Monocyclic, bacterially produced or semisynthetic beta-lactam antibiotics. They lack the double ring construction of the traditional beta-lactam antibiotics and can be easily synthesized.

A beta-lactamase inhibitor with very weak antibacterial action. The compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus extending their spectrum activity. Combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone.

More From BioPortfolio on "The Efficacy of Prolonged Antibiotic Therapy for the Prevention of Relapsing Peritonitis in Peritoneal Dialysis Patients With High Dialysis Effluent Bacterial DNA Fragment Levels"

Quick Search


Searches Linking to this Trial