EARLY TOPIC TREATMENT OF EXIT SITE INFECTION IN PERITONEAL DIALYSIS: PROPOSAL OF A NEW PROTOCOL

Introduction: Exit site infections (ESIs), the most common complication in peritoneal dialysis (PD), are responsible for 20% of peritonitis, 20% of catheter removals and 15-20% of patients transfer to hemodialysis. Therefore, ESIs’ prevention plays a crucial role in the care of PD patients. ESIs should be early detected and treated to avoid the evolution to complications such as tunnel infections, secondary peritonitis and catheter removal. Materials and methods: We propose with a single-centre, prospective, open-labelled pilot study a new protocol for prevention, early detection and treatment of ESI with peri-catheter antibiotic instillation in 20 patients. Outcomes analysed included tunnel infection rate, peritonitis rate, causative organisms and catheter removals as result of infection. Results: The adoption of the new protocol based on early topic treatment of ESI with peri-catheter antibiotic instillation in our Nephrology and Dialysis Unit showed a lower incidence rate of ESI, no tunnel infections, no peritonitis and no catheter removal during the 2.5 years follow-up compared to a traditional protocol previous used. Conclusion: Our protocol, based on early topic treatment of ESI seems to improve PD patient management, increasing catheter survival and reducing the incidence of complications.