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Journal of the Korean Society of Pediatric Nephrology 2008;12(2): 213-220. doi: https://doi.org/10.3345/JKSPN.2008.12.213
소아 복막 투석 환자에서 발생한 복막염의 경험적 항생제 치료에 관한 연구
이상구, 조중범, 손영배, 박성원, 김수진, 진동규, 백경훈
1성균관대학교 의과대학 삼성서울병원 소아청소년과
2성균관대학교 의과대학 삼성서울병원 소아청소년과
3성균관대학교 의과대학 삼성서울병원 소아청소년과
4성균관대학교 의과대학 삼성서울병원 소아청소년과
5성균관대학교 의과대학 삼성서울병원 소아청소년과
6성균관대학교 의과대학 삼성서울병원 소아청소년과
7성균관대학교 의과대학 삼성서울병원 소아청소년과
Peritoneal Dialysis Associated Peritonitis and Empirical Antibiotics Therapy in Korean Children with Chronic Renal Failure
Sang-Goo Lee, Joong-Bum Cho, Young-Bae Sohn, Sung-Won Park, Su-Jin Kim, Dong-Kyu Jin, Kyung-Hoon Paik
1Department of Pediatrics, Samsung Medical Center Sungkyunkwan University School of Medicine
2Department of Pediatrics, Samsung Medical Center Sungkyunkwan University School of Medicine
3Department of Pediatrics, Samsung Medical Center Sungkyunkwan University School of Medicine
4Department of Pediatrics, Samsung Medical Center Sungkyunkwan University School of Medicine
5Department of Pediatrics, Samsung Medical Center Sungkyunkwan University School of Medicine
6Department of Pediatrics, Samsung Medical Center Sungkyunkwan University School of Medicine
7Department of Pediatrics, Samsung Medical Center Sungkyunkwan University School of Medicine
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ABSTRACT
Purpose : This study aims to verify the effectiveness of initial empirical antibiotic choice recommended by the International Society for Peritoneal Dialysis(ISPD) guide among Korean children.
Methods : We have collected data on peritonitis from January 2001 to December 2007 in Samsung Medical Center.
Results : Of the 42 patients, 48 episodes of peritonitis had occurred in 21 patients. The rate of peritonitis was one episode over 35.3 patient-months. Mean dialysis duration before peritonitis was 18.06$pm$15.81 months. Gram-positive organisms accounted for 58.3% of all episodes. Of the gram-positive organisms, the most common pathogen was Staphylococcus aureus(29.2%), the next common pathogens were Coagulase negative staphylococcus(14.6%) and Streptococcus species(6.3%). 35.7% of gram-positive pathogens were resistant to 1st cephalosporin. However, in patients younger than 4 years old, 50% of gram-positive pathogens were resistant to 1st generation cephalosporin. 10 episodes of peritonitis were methicillin-resistant and were treated by vancomycin. Of the gram-negative organisms, E. coli was the most common (8.3%). 64.8% of all pathogens were sensitive to cephalothin or ceftazidime.
Conclusion : The empirical therapy with 1st generation cephalosporin and ceftazidime can be also effective to peritoneal dialysis associated peritonitis in Korean children. However, in patients younger than 4 years old, glycopeptide should be considered as the first empirical therapy in Korean children.
Key words: Peritonitis | Methicillin-resistant | Staphylococcus aureus
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