Oral pefloxacin mesylate in the treatment of continuous ambulatory peritoneal dialysis associated peritonitis: an open non-comparative study

Abstract

Twenty-two (15 female and 7 male) patients with continuous ambulatory peritoneal dialysis (CAPD) associated peritonitis were entered into an open non-comparative evaluation of oral pefloxacin mesylate. An initial loading dose of 800 mg was followed by 400 mg twice daily. Five patients were subsequently excluded or withdrawn. The mean age of the patients was 44 +/- 12.6 years. All three Gram-negative infections (Escherichia coli, Acinetobacter calcoaceticus, Serratia liquefaciens) and all three culture negative infections were cured after 21 days treatment. In contrast one of four (25%) Staphylococcus aureus infections was cured, two persisted during treatment and one relapsed, after treatments of between 10 and 25 days. One of seven (14%) Staph. epidermidis infections was cured, three persisted and three relapsed after treatments of between nine and 25 days. Two of the five persistent isolates became resistant: all four relapsed isolates remained sensitive. Twelve of the 22 (55%) patients had 16 side effects, most commonly skin or musculo-skeletal. Three stopped pefloxacin because of them, though one had taken an excessive dose in error. Pefloxacin mesylate is not optimal treatment for Gram-positive coccal peritonitis in patients on CAPD, but its role in Gram-negative disease needs further evaluation.