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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.