Questions About PD
We thank you for your question. Unfortunately, we are not able to comment on your use of Betadine for disinfecting the medication port of the of the PD solution bag. The latest ISPD peritonitis guidelines do not mention disinfecting the medication port of the PD solution bag (1). There is very limited research on this topic. One recently published study from Brazil conducted in a laboratory found that the sample/medication port of the PD solution bag should be scrubbed with 2% chlorhexidine for at least 5 seconds; if alcohol 70% is used the length of friction should be for at least 10 seconds; however, neither Alcavis nor Betadine were used in this study (2). From an informal survey of members of the ISPD Nurse Committee (from Australia, Brazil, Canada, New Zealand, the United Kingdom and the United States) most of the PD nurses in the home PD units we are familiar with use sterile, single-use, flat pads of either 70% isopropyl alcohol or 2% chlorhexidine gluconate in 70% isopropyl – hand hygiene first, clean medication port with disinfectant using friction, allow disinfectant to dry (to maximize effectiveness), before using aseptic non-touch technique to inject the medication IP (3). For one member of our group, their local practice is with using Alcavis 50 (place soaked 2 x 2 sterile gauze with Alcavis 50 on medication port and leave in place for two minutes). Clearly this is an area that would benefit from further research.
1.Li PK, Chow KM, Cho Y, Fan S, Figueiredo AE, Harris T, Kanjanabuch T, Kim YL, Madero M, Malyszko J, Mehrotra R. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Peritoneal Dialysis International. 2022 Mar;42(2):110-53.
2.Conti A, Katzap RM, Poli‐de‐Figueiredo CE, Pagnussatti V, Figueiredo AE. Disinfection of the peritoneal dialysis bag medication port: Comparison of disinfectant agent and disinfection time. Nephrology. 2018 Sep;23(9):863-6. Available at: http://www.repositorio.pucrs.br/dspace/bitstream/10923/23152/2/Disinfection_of_the_peritoneal_dialysis_bag_medication_port_Comparison_of_disinfectant_agent_and_disinfection_time.pdf
3.British Columbia (BC) Renal, Provincial Health Services Authority: PD Procedures – Adding Medication to Dialysate Solutions, December 2018. Available at: http://www.bcrenal.ca/resource-gallery/Documents/Adding%20Medication%20To%20Dialysate%20Solution.pdf