Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis 2023 May 26
ISPD Catheter-related Infection Recommendations: 2023 Update.
Abstract
Peritoneal dialysis (PD) catheter-related infections are important risk factors for catheter loss and peritonitis. The 2023 updated recommendations have revised and clarified definitions and classifications of exit site infection and tunnel infection. A new target for the overall exit site infection rate should be no more than 0.40 episodes per year at risk. The recommendation about topical antibiotic cream or ointment to catheter exit site has been downgraded. New recommendations include clarified suggestion of exit site dressing cover and updated antibiotic treatment duration with emphasis on early clinical monitoring to ascertain duration of therapy. In addition to catheter removal and reinsertion, other catheter interventions including external cuff removal or shaving, and exit site relocation are suggested.
Related Questions
How do you modify your peritonitis prevention strategy for a patient starting peritoneal dialysis who has a history of recurrent staphylococcal skin infections?
At the outset, let me state that I am unaware of any published data regarding this issue. Nor do I have personal experience to draw upon. So, what follows is what I THINK I would do if faced with this situation.First off, I would have a rather high threshold for starting PD in such a patient, especi...
Do you recommend daily topical exit site antibiotic use for patients with a peritoneal dialysis catheter that is only currently being accessed for once weekly flushes?
No. When PD catheters are being accessed only once weekly for flushes, we keep the exit site under a sterile dressing with a chlorhexidine-gluconate-impregnated disc surrounding the exit site. The catheter is accessed only by the PD nurse at the time of flushing, and we do not have the patient perfo...