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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

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Peritonitis