Intraperitoneal ampicillin treatment for peritoneal dialysis- related peritonitis with Listeria monocytogenes - a case report
Authors: Boss, Kristina; Wiegard-Szramek, Ina; Dziobaka, Jan; Kribben, Andreas; Dolff, Sebastian
BackgroundPeritoneal dialysis (PD)-related peritonitis is a rare but serious complication and is associated with increased morbidity and mortality rates. It is most commonly caused by Staphylococcus aureus or Staphylococcus epidermidis, but infection with Listeria monocytogenes may also occur. Recommendations for antibiotic treatment of a Listeria infection are currently based on a small number of case reports and suggest the administration of ampicillin. But unlike vancomycin or gentamicin, for ampicillin the route of application, the dosage, and the duration of treatment have not yet been established. We report a case in which PD-associated peritonitis due to Listeria infection was treated with ampicillin administered intravenously and intraperitoneally, separately and in combination.Case presentationA 72-year-old man with chronic kidney disease stage 5 dialysis (CKDG5D) secondary to hypertension and diabetes was hospitalised in April 2020 because of PD-related peritonitis caused by a Listeria infection. In accordance with the results of resistance tests, the patient was treated with intravenous ampicillin at a dosage of 6g twice daily. After initial treatment the leukocyte count in the PD effluent had decreased substantially, but it was permanently reduced only with the addition of intraperitoneal ampicillin (4g daily). Efficient serum concentrations of ampicillin were determined for both routes of administration, intravenous and intraperitoneal.ConclusionThis is the first case report demonstrating that PD-related peritonitis due to Listeria monocytogenes infection can be treated with intraperitoneal ampicillin and monitored by the determination of peripheral serum concentrations of ampicillin.
South Asian medicinal plants and chronic kidney disease
TRADITIONAL MEDICINE RESEARCH
Authors: Amarasiri, Sachinthi Sandaruwani; Attanayake, Anoja Priyadarshani; Jayatilaka, Kamani Ayoma Perera Wijewardana; Mudduwa, Lakmini Kumari Boralugoda
Chronic kidney disease remains as one of the serious health issues in South Asia. The paucity of effective pharmacotherapy targeting the management of chronic kidney disease has led to a search for alternative pharmacologic therapies. The traditional knowledge of medicinal plants plays a key role in the discovery of novel nephroprotective agents. This review aims to present the use of such South Asian ethnomedicinal plants that have sufficient therapeutic potency for the management of kidney diseases. Medicinal plants are rich sources of bioactive compounds that have been reported to exert nephroprotective mechanisms, such as antioxidant, anti-inflammation, diuretic, and immunomodulation. Many South Asian medicinal plants have been detailed in traditional medicinal pharmacopoeias for the management of kidney-related diseases. Some have shown promising effects to address nephropathy in animal models and in vitro research. This information can be beneficial in the development of novel pharmaceutical agents targeting the management of kidney diseases and improvement of quality of life for chronic kidney disease patients by fulfilling the requirements for disease management unmet by modern allopathic medicine.