Questions About PD
There are several case reports of peritonitis occurring shortly after colonoscopy, presumably due to translocation of organisms across the bowel wall into the peritoneal cavity. Unfortunately, there are no data to guide practice in terms of the optimal prophylactic regimen. Any regiman that would cover the likely organisms (enterococcus, gram negative enterics and anaerobes) would be appropriate. If one wanted to use IV antibiotics, one regimen might be ampicillin, gentamicin or a 3rd generation cephalosporin, and flagyl po. If given IP, one could give ampicillin, gentamicin or 3rd generation cephalosporin, and flagyl po. If given orally, one could use amoxicillin, ciprofloxacin and flagyl. If penicillin allergic, Vanco IV or IP could replace ampicillin. In addition, all patients should empty their peritoneal cavity of dialysate before the procedure.