I would like Table 4 of ISPD 2010 guidelines which is entitled "for CAPD patients" clarified please. – The 'continuous' column – does this suggest for a CAPD patient that one should give the LD for one exchange EVERY 24hrs, then the MD in remaining exchanges OR the LD for the first exchange, and then MD in all subsequent exchanges (ie don't give the large dose again)? – With regard to dosing antibiotics in CCPD – If giving continuous antibiotics, is it appropriate to use the Table 4 continuous column recommendation for the dosing (although it states for "CAPD patients")? If so, should you use the LD in a prolonged dwell to start, then MD in cycling exchanges, followed by then the large LD dose in day time dwell every day, OR should you just continue to use MD dose in all subsequent exchanges including the daytime dwell?

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Chanel P, Doctor/MD from Vancouver asked
I would like Table 4 of ISPD 2010 guidelines which is entitled "for CAPD patients" clarified please. – The 'continuous' column – does this suggest for a CAPD patient that one should give the LD for one exchange EVERY 24hrs, then the MD in remaining exchanges OR the LD for the first exchange, and then MD in all subsequent exchanges (ie don't give the large dose again)? – With regard to dosing antibiotics in CCPD – If giving continuous antibiotics, is it appropriate to use the Table 4 continuous column recommendation for the dosing (although it states for "CAPD patients")? If so, should you use the LD in a prolonged dwell to start, then MD in cycling exchanges, followed by then the large LD dose in day time dwell every day, OR should you just continue to use MD dose in all subsequent exchanges including the daytime dwell?

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For CAPD paients, the loading dose is given only ONCE – with the first exchange in which antibiotics are administered. Add the maintenance dose for each subsequent exchange.

For CCPD patients, when you dose the antibiotics continuously, you add the loading dose to a long-day dwell as you indicated, and the maintenance dose from the second column for Table 4 for each subsequent exchange – both day time and for night-time cycling. The loading dose again needs to be given on day 1, all subsequent doses even in the day dwell are the maintenance doses.

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