Things to note: Secondary peritonitis
Empiric antibiotic therapy
- Intravenous fluids and nasogastric suction.
- Prompt surgical intervention is essential.
For surgical causes of peritonitis:
- Benzylpenicillin (penicillin G), IV, 2 million units every 6 hourly.
- Gentamicin, IV, 6 mg/kg daily.
- Metronidazole, IV, 500 mg 8 hourly.
As soon as patient can tolerate oral medication:
- Metronidazole, oral, 400 mg 8 hourly.
For spontaneous bacterial peritonitis:
- Ceftriaxone, IV, 1 g daily.
Switch to oral therapy if the culture or treatment is clinically appropriate:
- Ciprofloxacin, oral, 500 mg 12 hourly.
- Total duration of therapy: 14 days.