Effect of Local Polyhexanide Application in Preventing Exit-Site Infection and Peritonitis: A Randomized Controlled Trial.

Autor: Ceri M; Department of Nephrology, Pamukkale University Faculty of Medicine, Denizli, Turkey., Yilmaz SR; Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey., Unverdi S; Department of Nephrology, Sanko University Faculty of Medicine, Gaziantep, Turkey., Kurultak I; Department of Nephrology, Trakya University Faculty of Medicine, Edirne, Turkey., Duranay M; Department of Nephrology, Ankara Education and Research Hospital, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy [Ther Apher Dial] 2020 Feb; Vol. 24 (1), pp. 81-84. Date of Electronic Publication: 2019 Jul 07.
DOI: 10.1111/1744-9987.12836
Abstrakt: Topical antibiotic and antiseptic agents have been documented to reduce exit-site infection (ESI) and peritonitis in PD. The aim of this randomized controlled study was to evaluate the efficacy of polyhexanide in the prevention of ESI and peritonitis. Patients were excluded if they had active infection, > 18 years of age, ESI and peritonitis within the previous 4 weeks, received PD for less than 3-months and history of allergy to either drug. All patients were followed up until catheter removal, death, switch to dialysis, transplantation or the end of the study. ESI, tunnel infection, peritonitis, catheter removal and microorganism cause of catheter-related infection were recorded prospectively during clinic follow-up. A total of 88 patients (41 povidone-iodine group; 47 polyhexanide group) were enrolled with a total follow-up duration of 480 and 555 patient-months for povidone-iodine and alternating group, respectively. There were no significant differences in the age, sex, BMI, time of PD, rate of DM, and S. aureus carriage state. A total of 8 ESI and 25 peritonitis episodes were detected during the study. ESI and peritonitis rates tended to be lower in polyhexanide group compared with the povidone-iodine group (0.06 episodes/patient-year vs. 0.12 episodes/patient-year; 0.26 episodes/patient-year vs. 0.32 episodes/patient-year, respectively), but were not significant statistically. Moreover, catheter removal was similar in both groups (0.04 / patient-year vs. 0.05 / patient-year). Polyhexanide is efficient and safe for the prevention of ESI and peritonitis and it may be used as an alternative procedure for the care of healthy exit sites.
(© 2019 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.)
Databáze: MEDLINE
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