How to Treat Peritonitis?

Things to note:
Secondary peritonitis

• Intravenous fluids and nasogastric suction.
• Prompt surgical intervention is essential.

Medical Treatment:
Empiric antibiotic therapy
For surgical causes of peritonitis:

• Benzylpenicillin (penicillin G), IV, 2 million units every 6 hourly.

PLUS

• Gentamicin, IV, 6 mg/kg daily.

PLUS

• 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.