Peritonitis

Infection

Peritonitis

Possible therapeutic alternatives

Spontaneous bacterial peritonitis (primary).

Duration: 5 - 14 days depending on patient response

Common pathogens

Piperacillin-tazobactam 3.375 grams IV every 6 hours OR

Ticarcillin-clavulanic acid 3.1 grams ivpb every 6 hours OR

Cefotaxime 2 grams IV every 8 hours or

Ceftriaxone 2 grams ivpb q24h OR

Ertapenem 1gram IV q 24h OR

Ciprofloxacin 400mg IV q12h or Levofloxacin 750mg IV qd

Resistant species

Imipenem 500mg IV every 6 hours OR
doripenem 500mg IV every 8 hours, OR
meropenem 1 gram IV q8h.

"Secondary" bowel perforation, ruptured appendix etc.

Common pathogens

Single drug therapy:

Ticarcillin-clavulanic acid 3.1 grams IV every 6 hours OR

Piperacillin-tazobactam 3.375 grams IV every 6 hours OR

Ertapenem 1gram IV q 24h OR

Cefoxitin 1- 2 grams IV q6h OR

Severe Disease

Imipenem 500mg IV every 6 hours OR
doripenem 500mg IV every 8 hours, OR
meropenem 1 gram IV q8h.

Combination therapy:

[Cefotaxime 2 grams every 6 to 8hours OR
Cefepime 2 grams q12h OR
Aztreonam 1-2 grams IV every 6 or 8 hours OR
Ciprofloxacin 400mg IV every 12 hours ]

PLUS
Metronidazole 500mg ivpb every 6 to 8 hours.

PPenicillin allergic patient:

[Ciprofloxacin 400mg IV every 12 hours
+
Metronidazole 500mg IV every 6 to 8 hours]

or
[ Aztreonam + Metronidazole ]

Infection

Resistant species

Severe Disease

Images