부산대학교 도서관

Background: Exit site infection (ESI) is a significant contributing factor to high mortality and poor treatment outcomes in peritoneal dialysis (PD) patients. The aim of this review of clinical practice was to compare the effectiveness of two commonly used antiseptic solutions in PD exit site care. Objective: To investigate if 2% chlorhexidine aqueous is more effective in PD exit site care when compared with 10% povidone-iodine for treatment of acute and suspected ESIs. Context: A community dialysis unit and nephrology ward in regional Australia. Methods: A retrospective review was conducted to compare the infection rate of using two different antiseptic solutions on acute and suspected infectious PD exit site care. From February 2012 a change in clinical practice was implemented; all existing PD patients were switched to 2% chlorhexidine aqueous solution from 10% povidone-iodine for treatment of acute and suspected ESIs. Infection rates were retrospectively identified for patients using 10% povidone-iodine in 2011 and compared with the infection rates for patients using 2% chlorhexidine aqueous in 2012. Results: ESI rate decreased from 14 episodes (average 1 in 69 patient-months) in 2011 to 5 episodes (average 1 in 165 patient-months) in 2012. Conclusion: This project provides data indicating that chlorhexidine aqueous is a good alternative antiseptic solution in the management of PD ESI when compared with povidone-iodine. Chlorhexidine aqueous may be more suitable for use as the first-line antiseptic solution on acute exit sites and suspected ESI. Keywords ESI, infection, exit site, PD, chlorhexidine, peritoneal dialysis, povidone-iodine
Introduction Peritoneal dialysis (PD) is an effective treatment for end-stage kidney disease (ESKD) and is a good choice for patients wishing to perform a home dialysis modality (Lee & Park, [...]