Topical Honey in the Management of Pediatric Peritoneal Dialysis Exit Sites.
Perit Dial Int
; 36(6): 684-687, 2016.
Article
en En
| MEDLINE
| ID: mdl-27903852
ABSTRACT
International guidelines in peritoneal dialysis (PD) advocate for regular application of topical mupirocin in chronic PD exit-site care. A strong evidence base links this treatment to reduced rates of exit-site infections and peritonitis. However, emerging reports of increasing mupirocin resistance and gram-negative infections are threatening the long-term viability of topical antibiotic ointments as a prophylactic treatment. Medical grade honey has multiple proven antibacterial and wound healing properties. High-quality randomized controlled trial evidence (the HONEYPOT trial), however, does not support the use of topical medical-grade honey over antibiotic ointments for the prevention of exit-site infection and peritonitis in adults. Pediatric representation in these studies is low, and these findings may not extrapolate to the pediatric context, which has a higher incidence of PD-related infection and a lower prevalence of diabetes.We present a series of 8 pediatric patients treated with topical Medihoney (Comvita, Paengaroa, New Zealand) in the context of poor exit-site condition, persistent infection, and recurrent granuloma where the addition of honey was felt to produce remarkable improvement in exit-site status.Medihoney is the first-line prophylactic exit-site ointment in PD exit sites at our institution and has been implicated in the salvage of peritoneal access in some patients. No exclusively pediatric studies have been performed; however, existing literature suggests a beneficial effect in promoting healing of infected wounds with a lower risk of developing antimicrobial resistance.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Peritonitis
/
Catéteres de Permanencia
/
Diálisis Peritoneal
/
Miel
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Perit Dial Int
Asunto de la revista:
NEFROLOGIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Australia