ANTIBIOTIC-TREATMENT FOR PERITONITIS

Antibiotic treatment must be used in addition to surgery to treat peri tonitis. This is an empiric treatment, started as soon as possible, an d before surgery. Selected antibiotics should be active against both a erobic and anaerobic bacteria. Activity against Enterococcus is not ma ndatory and the efficacy of cephalosporins, in combination or not with a drug active against anaerobic bacteria, has long been known. Antibi otic combination is not required if the selected drug, like cefotetan, is active against potentially pathogen bacteria. In case of nosocomia l peritonitis, the antibiotic strategy must be modified to gain activi ty against multiresistant Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter and fungi (like Candida albicans). Broad-spectrum antibi otics, such as cefepime, cefpirome (in combination with a drug active against anaerobic bacteria) or imipenem-cilastin, are selected. Amphot ricin B or fluconazole can be added when needed.