Streptococcal peritonitis in patients on peritoneal dialysis: Antibiotic selection

IgE: Immunoglobulin E.

* The initial empiric antibiotic regimen covers both gram-positive and gram-negative organisms, and should be narrowed after a specific susceptible organism is identified. Refer UpToDate content on microbiology and therapy of peritonitis in peritoneal dialysis for details.

¶ There is no consensus on the optimal timing and duration of antifungal prophylaxis. We administer antifungal prophylaxis if antibiotics are administered for longer than 3 days; other experts do so for any course longer than 1 day. The duration of antifungal prophylaxis varies: prophylaxis is continued for the full antibiotic course, but we generally extend the duration by an additional week. Refer to UpToDate content on fungal peritonitis in peritoneal dialysis for details.

Δ Streptococcal isolates that are not tested can generally be assumed to be susceptible to penicillin and cephalosporins.

◊ Type 1 allergic reactions are acute IgE-mediated allergies that typically manifest as various combinations of hives (urticaria), pruritus, angioedema, bronchospasm (eg, wheezing), or hypotension. The majority of patients with reported beta-lactam allergies do not have type 1 allergies and can take a cephalosporin. Refer to UpToDate content on penicillin allergies for details.