PD Peritonitis Treatment Duration — ESENeph MCQ

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EasyPeritoneal DialysisPD Peritonitis Treatment DurationESENeph

A 50-year-old man on peritoneal dialysis presents with cloudy effluent. Cell count shows WCC 250/mm3 (90% neutrophils). Culture grows coagulase-negative Staphylococcus. He is treated with IP Vancomycin and Ceftazidime. After 5 days, the effluent is clear and repeat culture is negative. What is the minimum total treatment duration?

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Correct answer: D — 14 days

This is peritoneal dialysis-associated peritonitis: cloudy effluent with dialysate WCC >100/mm3 and >50% neutrophils. The culture has grown coagulase-negative Staphylococcus, a common gram-positive cause that typically responds well to intraperitoneal vancomycin or a cephalosporin according to susceptibility. Current ISPD guidance recommends treating coagulase-negative staphylococcal peritonitis for 2 weeks. Clinical improvement by day 5 and a negative repeat culture confirm response, but they do not shorten the minimum total antibiotic course. Therefore the minimum total duration is 14 days.

Reference: International Society for Peritoneal Dialysis (ISPD) Peritonitis Guideline Recommendations: 2022 Update on Prevention and Treatment. Peritoneal Dialysis International. 2022;42(2):110-153. https://journals.sagepub.com/doi/10.1177/08968608221080586