TAILIEUCHUNG - Chapter 121. Intraabdominal Infections and Abscesses (Part 3)

Primary Bacterial Peritonitis: Treatment Treatment for PBP is directed at the isolate from blood or peritoneal fluid. Gram's staining of peritoneal fluid often gives negative results in PBP. Therefore, until culture results become available, therapy should cover gram-negative aerobic bacilli and gram-positive cocci. Third-generation cephalosporins such as cefotaxime (2 g q8h, administered IV) provide reasonable initial coverage in moderately ill patients. Broad-spectrum antibiotics, such as penicillin/β-lactamase inhibitor combinations (., piperacillin/tazobactam, g q6h IV for adults with normal renal function) or ceftriaxone (2 g q24h IV), are also options. Empirical coverage for anaerobes is not necessary. After the infecting organism. | Chapter 121. Intraabdominal Infections and Abscesses Part 3 Primary Bacterial Peritonitis Treatment Treatment for PBP is directed at the isolate from blood or peritoneal fluid. Gram s staining of peritoneal fluid often gives negative results in PBP. Therefore until culture results become available therapy should cover gram-negative aerobic bacilli and gram-positive cocci. Third-generation cephalosporins such as cefotaxime 2 g q8h administered IV provide reasonable initial coverage in moderately ill patients. Broad-spectrum antibiotics such as penicillin 0-lactamase inhibitor combinations . piperacillin tazobactam g q6h IV for adults with normal renal function or ceftriaxone 2 g q24h IV are also options. Empirical coverage for anaerobes is not necessary. After the infecting organism is identified therapy should be narrowed to target the specific pathogen. Patients with PBP usually respond within 72 h to appropriate antibiotic therapy. Antimicrobial therapy can be administered for as little as 5 days if rapid improvement occurs and blood cultures are negative but a course of up to 2 weeks may be required for patients with bacteremia and for those whose improvement is slow. Persistence of WBCs in the ascitic fluid after therapy should prompt a search for additional diagnoses. Prevention PBP has a high rate of recurrence. Up to 70 of patients experience a recurrence within 1 year. Antibiotic prophylaxis reduces this rate to 20 . Prophylactic regimens for adults with normal renal function include fluoroquinolones ciprofloxacin 750 mg weekly norfloxacin 400 mg d or trimethoprim-sulfamethoxazole one double-strength tablet daily . However longterm administration of broad-spectrum antibiotics in this setting has been shown to increase the risk of severe staphylococcal infections. Secondary Peritonitis Secondary peritonitis develops when bacteria contaminate the peritoneum as a result of spillage from an intraabdominal viscus. The organisms found almost always .

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• Intraabdominal Infections and Abscesses
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu học ngành y
• Harrisons Internal Medicine
• medical books
• pharmacology
• epidemiologic
• Obstetrics
• anatomy
• Preventing Morbidity
• Multidisciplinary Care