Abstract
Antibiotherapy is a fundamental for the treatment of peritonitis. It may be used before surgery or as a complementary treatment after. Experimental models have demonstrated that infections are both aerobic and anaerobic. During the first stage, septicemic with a high death rate, the infection is due to enterobacteria, mostly Escherichia coli. Between D5 and D7 in surviving animals, there is a second stage with abscesses due to anaerobic bacteria, mostly Bacteroides fragilis. The antibiotic treatment must include these two types of bacteria in its spectrum. The role of Enterococcus faecalis is not clearly defined, but this bacterium must be taken into account in case of organ failure or associated septic shock. Treatment options for secondary peritonitis may be, according to severity, cefoxitin, an Augmentin + gentamycin combination, Tazocillin, or ertapenem. The reference treatment for nosocomial or tertiary peritonitis is the imipenem + amikacin combination. An antifungal treatment (fluconazole) is usually necessary, at least until the results of peritoneal fluid culture are available. The duration of treatment is quite variable, ranging from 48 h in less severe forms to 14 days.
MeSH terms
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Abdominal Abscess / drug therapy
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Abdominal Abscess / microbiology
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Animals
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Anti-Bacterial Agents / classification
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Anti-Bacterial Agents / pharmacokinetics
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Anti-Bacterial Agents / therapeutic use*
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Antifungal Agents / therapeutic use*
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Bacteremia / drug therapy
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Bacteremia / microbiology
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Bacteroides Infections / drug therapy
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Bacteroides Infections / microbiology
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Bacteroides Infections / surgery
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Case Management
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Combined Modality Therapy
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Cross Infection / drug therapy
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Cross Infection / microbiology
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Cross Infection / surgery
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Drug Resistance, Multiple, Bacterial
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Fungemia / drug therapy
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Fungemia / microbiology
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Gram-Negative Aerobic Bacteria / drug effects
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Gram-Negative Aerobic Bacteria / isolation & purification
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Gram-Negative Anaerobic Bacteria / drug effects
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Gram-Negative Anaerobic Bacteria / isolation & purification
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Gram-Negative Bacterial Infections / drug therapy
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Gram-Negative Bacterial Infections / microbiology
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Gram-Negative Bacterial Infections / surgery
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Humans
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Mycoses / drug therapy
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Mycoses / surgery
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Peritonitis / drug therapy
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Peritonitis / microbiology
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Peritonitis / mortality
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Peritonitis / surgery
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Peritonitis / therapy*
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Rats
Substances
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Anti-Bacterial Agents
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Antifungal Agents