We currently have a patient with a profuse pseudomonas aeruginosa exit site infection (nil tunnel involvement). It was treated PO Ciprofloxacin and has not responded. The treating Nephrologist was interested to know if topical Gentamicin has ever been used and if so if it has proven effective against pseudomonas exit site infections. Any other information you have on successfully treating pseudomonas exit site infections would be appreciated also.
ANSWEREDLauren M answered November 2, 2016
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 I have a patient who previously had a MDR serratia peritonitis and than a fungal peritonitis followed by removal of the PD catheter. He is now running out of all vascular access and having multiple problems maintaining it. I do have an option of getting a translumbar HD catheter but I want any input regarding maybe putting him back on PD. I wanted to know if with the 2 previous infections, which were more than 9 months ago now, is their an absolute contraindication against putting him back on PD.
ANSWEREDzubair, A answered July 24, 2016
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 Message Body:I am reviewing our policy for pts undergoing a colonoscopy.All PD pts get in order of preference1. cipro 200mg prior to procedure. if allergic use #22. ampicillin 2 gms plus gentamycin 1 mg/kg prior to procedure3 If allergic to PCN use vancomycin4. neomycin or tobramycin may be given in place of gentamycin– the GI physician may also order 2 doses of metronidazole, po 6 to 8 hours apart on the day of the colonoscopy.Could you please tell me if this is still the best practice. Our policy was written in 2012.Thanks – Sue Reed
ANSWEREDSusan R answered June 17, 2016
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