Nochaiwong et al reported a simple score for predicting the risk of antibiotic therapy failure in a patient with peritonitis secondary to peritoneal dialysis. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple insitutions in Thailand and Canada.
Patient selection: peritonitis associated with peritoneal dialysis
Treatment failure: (1) need for catheter removal, (2) change to hemodialysis, (3) peritonitis-associated mortality
Parameters:
(1) diabetes mellitus
(2) systolic blood pressure in mm Hg
(3) dialysate leukocyte count on day 3-4
(4) dialysate leukocyte count on day 5
Parameter
Finding
Points
diabetes mellitus
no
0
yes
1
systolic blood pressure
>= 90 mm Hg
0
< 90 mm Hg
2.5
dialysate WBC count day 3-4
<= 1,000 per µL
0
> 1,000 per µL
1.5
dialysate WBC count day 5
<= 100 per µL
0
> 100
6.5
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 11.5
• The higher the score the greater the risk.
Score
Risk Group
Rate of Failure
0 to 1
low
3%
1.5 to 9
moderate
54%
> 9
high
90%
Performance:
• The area under the ROC curve was 0.02
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