Original investigation
A prospective randomized control study of oral nystatin prophylaxis for candida peritonitis complicating continuous ambulatory peritoneal dialysis

https://doi.org/10.1016/S0272-6386(96)90466-7Get rights and content

Abstract

A prospective randomized study of the prevention of candida peritonitis (CP) in continuous ambulatory peritoneal dialysis patients using oral nystatin given concomitantly with antibiotic therapy was carried out for 2 years. Patients were randomized into twp groups. Nystatin tablets 500,000 units four times a day were given to group 1 but not group 2 patients whenever antibiotics were prescribed. There were 199 patients at risk (mean follow-up, 18.0 months) in group 1 and 198 patients at risk (mean follow-up, 16.6 months) in group 2. The peritonitis and antibiotic prescription rates were comparable between the two groups. There were four episodes of CP in four patients in group 1 and 12 episodes in 11 patients in group 2. The probability of CP-free survival at 2 years was higher in group 1 compared with group 2 (0.974 v 0.915; P < 0.05). However, only three (75%) CP episodes in group 1 and six (50%) in group 2 were considered “antibiotics related”. The incidence of antibiotics-related CP was 1.39 and 3.19 per 100 peritonitis episodes and 0.66 and 1.43 per 100 antibiotic prescriptions in groups 1 and 2, respectively (P = NS). We conclude that oral nystatin prophylaxis with each antibiotic prescription reduced the rate of CP in patients on continuous ambulatory peritoneal dialysis irrespective of its apparent temporal relationship to antibiotic prescription.

References (16)

There are more references available in the full text version of this article.

Cited by (100)

  • Clinical guide of the Spanish Society of Nephrology on the prevention and treatment of peritoneal infection in peritoneal dialysis

    2022, Nefrologia
    Citation Excerpt :

    The fact that between 56–89% of all such episodes appear after bacterial infection (whether peritoneal or otherwise) treated with antibiotics189,190,194 has generated recurrent interest over the last 30 years regarding the convenience of prescribing antifungal prophylaxis in these clinical contexts. Although multiple studies with low levels of evidence have been published, randomized trials195,196 and meta-analyses119,120 with positive outcomes have served as the basis of the ISPD guides of 2016 for supporting this measure. The guide does not include suggestions on other concrete clinical contexts, or on which antifungals are to be preferred or the duration of prophylaxis in these cases — though it does appear to acknowledge a certain advantage of azole drugs over nystatin14.

  • Peritoneal Dialysis Access Associated Infections

    2019, Advances in Chronic Kidney Disease
  • Peritoneal Dialysis-Related Infections

    2018, Chronic Kidney Disease, Dialysis, and Transplantation: A Companion to Brenner and Rector’s The Kidney
View all citing articles on Scopus
View full text