Polymicrobial
Suspect bowel source
consider surgical intervention
| Empiric Therapy |
Intermittent Dosing 1 exchange daily with dwell time at least 6h |
Continuous Dosing (per each L bag) |
Duration |
|---|---|---|---|
| Vancomycin IP |
15-30mg/kg q5-7days for CAPD 15mg/kg q4days for APD |
20-25mg/kg LD then 25mg/L MD | 21 days Consider catheter removal. |
| + | |||
| [Gentamicin IP | 0.6mg/kg once per day | Not advised | |
| or | |||
| Ciprofloxacin] |
500mg PO daily 750mg PO bid for CCPD |
50mg/L MD | |
| + | |||
| Metronidazole IV/PO | 500mg IV/PO q12h | 500mg IV/PO q12h | |
| or | |||
| Piperacillin-tazobactam IP monotherapy | no data |
4.5g LD then 1.125g MD |
21 days Consider catheter removal. |
| or | |||
| Meropenem IP monotherapy |
500mg once per day in long dwell APD 1g once per day in short dwell CAPD |
125mg/L MD | 21 days Consider catheter removal. |
APD = automated peritoneal dialysis
CAPD = continuous ambulatory peritoneal dialysis
CCPD = continuous cycling peritoneal dialysis
IP = intraperitoneally
LD = loading dose
MD = maintenance dose