Version July 2025
IgE: immunoglobulin E; S. aureus: Staphylococcus aureus.
* The initial empiric antibiotic regimen covers both gram-positive and gram-negative organisms, and should be narrowed after a specific susceptible organism is identified. Refer to UpToDate content on microbiology and therapy of peritonitis in peritoneal dialysis for details.
¶ There is no consensus on the optimal timing and duration of antifungal prophylaxis. We administer antifungal prophylaxis if antibiotics are administered for longer than 3 days; other experts do so for any course longer than 1 day. The duration of antifungal prophylaxis varies: prophylaxis is continued for the full antibiotic course, but we generally extend the duration by an additional week. Refer to UpToDate content on risk factors and prevention of peritonitis in peritoneal dialysis for details.
Δ Coagulase-negative staphylococci that are not tested should be treated as if they are resistant to methicillin and cephalosporins.
◊ Type 1 allergic reactions are acute IgE-mediated allergies that typically manifest as various combinations of hives (urticaria), pruritus, angioedema, bronchospasm (eg, wheezing), or hypotension. The majority of patients with reported beta-lactam allergies do not have type 1 allergies and can take a cephalosporin. Refer to UpToDate content on penicillin allergies for details.
§ For S. aureus infections, some experts add a rifamycin (eg, rifampin) for the first 5 to 7 days of therapy. Other experts add a rifamycin if there is inadequate response to initial therapy.
¥ For patients whose catheter is removed due to infection, we administer systemic (oral or intravenous) therapy. For first episodes of coagulase-negative staphylococcal infection, we administer 14 days of therapy from the date of catheter removal. For S. aureus and recurrent coagulase-negative staphylococcal infections, we ensure at least 14 days of antibiotics are administered from the date of catheter-removal and at least 21 total days of antibiotics are received.