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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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References - Infectious Disease Section

Infectious Disease References

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The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.
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