THE USE OF POVIDONE-IODINE IN EXIT SITE CARE FOR PATIENTS UNDERGOING CONTINUOUS PERITONEAL-DIALYSIS (CAPD)

Exit site infection is a major risk factor for the development of peri tonitis in continuous ambulatory peritoneal dialysis. The frequency of infection can be reduced by scrupulous exit site care with or without topical antiseptics. A randomized trial was performed of 149 catheter s in 130 patients to assess any additional benefits conferred by the u se of povidine iodine dry powder spray at dressing changes over an exi sting strict protocol of exit care. Exit infections occurred in 14 (18 %) of 77 patients using spray and in 15 (21%) of 72 patients not using spray. The risk of peritonitis was also similar in each group. The pr oportion of infections caused by Staphylococcus aureus was reduced in the spray group, but those caused by Pseudomonas aeruginosa were incre ased. Rash occurred in 6% of those using the spray. The use of the spr ay did not therefore seem justified.