The effect of propolis on the incidence of peritonitis in patients on continuous ambulatory peritoneal dialysis

INTERVENTION: Intervention 1: Intervention group: Every other day; in the morning after the dialysis the site of the catheter is washed with 0.9% normal saline and then 10% of the propolis ointment is used for 6 months. Intervention 2: Control group: Every other day; in the morning after the dialysis the site of the catheter is washed with 0.9% normal saline and then 2% Mupirocin ointment is used for 6 months. CONDITION: Peritonitis. ; Generalized (acute) peritonitis PRIMARY OUTCOME: Peritonitis is evaluated in the presence of Cloudy fluid, abdominal pain, white blood cell count of more than 100/ mm3 (at least 50% neutrophils), fever, and positive fluid dialysis culture. Timepoint: The patient will be assessed every two weeks for peritoneal dialysis. An aliquot of peritoneal effluent and a swab of exit site will be sent for culture monthly and in occasion of appearance of exit site secretion or peritonitis. The duration of assessment will continue for 6 months. Method of measurement: Symptoms of peritonitis are evaluated according to the International Society for Peritoneal Dialysis (ISPD) criteria. SECONDARY OUTCOME: Exit site of catheter and tunnel are monitored for signs of infection (redness, pain, warmness and swelling, secretion from the exit site of the catheter). Timepoint: The patient will be assessed every two weeks for infection signs. Monthly and with signs of infection and peritonitis, the culture of the catheter exit site and the dialysis output fluid will be sent for 6 months. Method of measurement: Inspection of redness, pain, warmness and swelling, secretion from the exit site of the catheter. INCLUSION CRITERIA: Patients aged 18‐60 years At least history of three months peritoneal dialysis Lack of acute infections At least 2‐4 sessions of peritoneal dialysis per day Lack of history of hypersensitivity to honey