Comparison of erythromycin and isoniazid in treatment of adverse reactions to BCG vaccination.

There is usually a latent period of between 24 and 72 hours from contamination of the peritoneal cavity to the onset of clinical peritonitis.2 Our four patients developed peritonitis due to S viridans two to seven days after the onset of a lesion in the mouth or dental surgery. Peritonitis in these patients probably resulted from haematogenous spread of the bacteria from the mouth. Although S viridans is always present in the mouth, it is only rarely cultured from the hands and from the sites of catheters in patients receiving continuous ambulatory peritoneal dialysis.3 We suggest that patients receiving continuous ambulatory peritoneal dialysis should be given antibiotic prophylaxis if they are to undergo dental surgery, using the same regimen as is advised for patients with lesions of their heart valves.4 Patients who are not allergic to penicillin should be given 3 g amoxycillin orally one hour before dental surgery, whereas those who are allergic or have recently taken a course of penicillin should be given 1-5 g erythromycin stearate orally one to two hours before the procedure and 0-5 g six hours later. In addition, we advise patients receiving continuous ambulatory peritoneal dialysis to use toothbrushes with soft bristles to minimise trauma to the gums.