Exit-site infection treatment?

• A. Oral analgesics alone.
• B. Only heat application.
• C. Avoid antibiotics.
• D. Topical antibiotic and good exit-site care; systemic antibiotics if needed.

Answer: (D)

Exit-site infections require active treatment of the infection at the catheter exit and ongoing, careful care of the site. The best approach is to use a topical antibiotic applied to the exit site along with diligent exit-site care (cleaning, dressing changes, and measures to prevent contamination during exchanges). If there are signs that the infection is deeper or not responding to topical therapy—such as redness or tenderness along the tunnel, fever, purulent drainage, or sustained failure to improve—systemic antibiotics are added. This combined approach helps prevent progression to tunnel infection or peritonitis.

Analgesics alone don’t treat the infection, heat application doesn’t eradicate the infectious process, and avoiding antibiotics allows the infection to worsen. The goal is to control the local infection promptly and escalate therapy only if the situation indicates deeper involvement or poor response.