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Clinical predictors for choice of empirical antibiotics between first- and second-line antibiotics are required to decrease the duration of peritonitis and avoid infection with antibiotic-resistant bacteria. The objective of this study is to identify the clinical factors that can predict the outcome of initial empirical antibiotic therapy using first-generation cephalosporin plus gentamicin for PD peritonitis. This single-center retrospective study of PD peritonitis covered a 10-year period from 1997 to 2006. PD peritonitis was diagnosed based on at least two of following criteria: clinical symptoms and signs; dialysate white blood cell count >100 cells/?L and neutrophils >50%; or positive dialysate Gram stain or culture (6). The dialysate sample used for Gram staining of suspected PD peritonitis was the sediments produced by centrifugation of the dialysate, and the dialysate culture for PD peritonitis was performed http://www.selleckchem.com/products/poziotinib-hm781-36b.html with direct broth inoculation of the BacT/Alert blood culture bottles (Becton Dickinson, Franklin Lakes, NJ, USA) routinely used in our hospital (19). The peritonitis episodes were treated empirically with intermittent intraperitoneal first-generation cephalosporin and gentamicin before the causative organisms were known. The patient characteristics such as age, sex, duration on PD, previous history of PD peritonitis, medical history of diabetes mellitus, peritoneum function, and PD types were recorded. The clinical symptoms associated with peritonitis, such as fever and abdominal pain, were analyzed. Initial http://en.wikipedia.org/wiki/MYO10 laboratory data, Gram stain results and cell counts of long-dwelling (>4?h) dialysate, blood cell counts, and serum albumin level were recorded. The results of dialysate culture were analyzed. The durations of empirical treatment with intermittent intraperitoneal first-generation cephalosporin and gentamicin were recorded. The dialysate cell count was assessed daily after starting empirical therapy until the dialysate white blood cell count was http://www.selleckchem.com/products/bay80-6946.html antibiotics. Dropping either one of the empirical antibiotics without adding second-line antibiotics was categorized as empirical treatment success. Changing either antibiotics to second-line antibiotics due to the persistent increase of white cell counts in the dialysate during the first five days or antibiotic insensitivity based on dialysate culture results, patient mortality, or PD catheter removal during the course of empirical antibiotic treatment was defined as empirical treatment failure. Generally, time of PD catheter removal was based on recommended guidelines (6); however, it varied among patients depending on clinical conditions. Peritonitis mortality was defined as patient death with active peritonitis.