Retrospective Analysis of the Impact of Prophylactic Interventions, in Reducing the Rate of Pd Peritonitis Pre and Post Covid Pandemic

ABSTRACT

Introduction: - Recurrent exit site infection and peritonitis are major causes of PD catheter removal and PD failure - 1/3 lead to hospitalizations - 5-10% lead to mortality - Reported rate in Australia is 0.6 episode/patient-year - Our first hypothesis is that implementing these prophylactic measures should lead to lower rates of PD peritonitis, PD catheter failure and mortality from 2017 onwards - Our second hypothesis is reduction in the impact of these prophylactic interventions during the covid pandemic Methods: - The aim of this study is to assess the impact of prophylactic interventions that were implemented in 2017 at Gosford hospital, particularly looking at the rates of PD peritonitis, PD catheter failure, transition to HD and mortality - The second aim of this project is to assess the effect of covid pandemic on these interventions Inclusion criteria - Adult (ages 18+) - Patients on peritoneal dialysis in the central coast renal unit - Duration from 2013-2022 - Intervention Prophylactic antibiotic therapy during PD catheter insertion, prophylactic anti-fungal therapy while on antibiotic therapy, nursing, and patient education - Exposure(s) - Prophylactic antibiotic and antifungal therapies, nursing, and patient education - Confounders - Covid pandemic - Primary outcome - Reduction in PD peritonitis - Secondary outcome(s) - PD catheter failure, transition to haemodialysis, mortality Results: - Our data demonstrates reduction in the rate of PD peritonitis and PD catheter failure following the implementation of prophylactic interventions. - There is no significant difference in the rate of PD peritonitis between the pre and post covid pandemic periods, as the prophylactic measures were still being implemented adequately as per hospital policy. Conclusion(s) - Administration of prophylactic antibiotic and antifungal therapies in PD patients is thought to reduce the rate of PD peritonitis, PD catheter failure and mortality based on our current guidelines. - Our research project has been designed to assess the clinical effectiveness of these prophylactic interventions, in addition to the impact of covid pandemic on these outcomes. No conflict of interestCopyright © 2023