Oral Antibiotics are Effective for Preventing Colonoscopy-associated Peritonitis as a Preemptive Therapy in Patients on Peritoneal Dialysis

Intern Med. 2021;60(3):353-356. doi: 10.2169/internalmedicine.5092-20. Epub 2021 Feb 1.

Abstract

Objective In patients on peritoneal dialysis (PD), it was reported that colonoscopy, but not upper gastrointestinal endoscopy, could cause peritonitis as a complication. A guideline of the International Society for Peritoneal Dialysis recommends preemptive intravenous antibiotics administration of ampicillin and aminoglycoside with or without metronidazole, to prevent colonoscopy-associated peritonitis. In this study, we retrospectively evaluated the effects of preemptive antibiotics therapy by oral administration instead of intravenous administration. Methods We investigated the incidence of colonoscopy-associated peritonitis in a single center. In 170 patients undergoing PD between January 2010 and December 2019, 50 colonoscopies were performed, including 49 with oral administration of amoxicillin and ciprofloxacin and/or metronidazole as preemptive therapy 1 hour before the colonoscopy procedure, and 1 without. Results We observed no incidence of colonoscopy-associated peritonitis. Conclusion Generally, oral administration of preemptive antibiotics is less painful and more convenient than intravenous administration, especially in outpatient procedures, such as a colonoscopy. Our results suggest that oral antibiotic administration might be effective for preventing colonoscopy-associated peritonitis in PD patients.

Keywords: colonoscopy; peritoneal dialysis; peritonitis; prophylactic antibiotics administration.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Colonoscopy
  • Humans
  • Peritoneal Dialysis* / adverse effects
  • Peritonitis* / epidemiology
  • Peritonitis* / etiology
  • Peritonitis* / prevention & control
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents