Abstract
Objectives: Exit-site care is important in prevention of Peritoneal Dialysis (PD) associated infections. But there was no clear recommendation for standard exit-site care. The aim of the study was compare local mupirocin and neomycin in exit-site care of chronic PD.
Methods: 32 children in chronic PD was included the study. The mean age was 11.3±4.8 years and mean follow-up period for dialysis before study was 15.9±10 months. The patients were randomized to mupirocin (n=16) or neomycin (n=16) groups and followed for 12 months. Mupirocin or neomycin was added to standard exit-site care with local dressing every alternate day.
Results: Total 313 patient follow-up months was recorded. Mean exit-site score at beginning and end of the study was not different in both groups. The increasing of the exit-site score between beginning and end of the study was significant in mupirocin group (p<0.01). Total 6 exit-site infection (3 culture negative, 1 MRSA, 1 pseudomonas and with 1 corynebacterium) was found in 4 patients. The incidence of exit-site infections was 24 treatment months in mupirocin group and no exit-site infection was found in neomycin group (p=0.036). Total 15 peritonitis (5 culture negative, 4 MRSA, 2 streptococcus, 2 staphylococcus, 1 E.coli, 1 enterococus) was recorded in 13 patients during study. The peritonitis incidence was not different between mupirocin and neomycin groups respectively (20.9 vs. 20.9 treatment months.
Conclusion: Neomycin is more effective then mupirocin for prevention of exit-site infection in children with chronic PD with relatively higher local adverse events.
Citation
Serdaroglu E, Toktay A, Ozdemir K and Bak M. Mupirocin or Neomycin for Exit-Site Care in Children with Chronic Peritoneal Dialysis. SM J Pediatr Surg. 2017; 3(1): 1037.