What is the role of antibiotic therapy in the treatment of peritonitis and abdominal sepsis?

Updated: Jul 23, 2019
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Antibiotic therapy is used to prevent local and hematogenous spread of infection and to reduce late complications. [25] Several different antibiotic regimens are available for the treatment of intra-abdominal infections. [25] Both single-agent broad-spectrum therapy and combination therapies have been used. However, no specific therapy has been found to be superior to another therapy. Infection of the abdominal cavity requires coverage for gram-positive and gram-negative bacteria, as well as for anaerobes. Antipseudomonal coverage is recommended in patients who have had previous treatment with antibiotics or who have had a prolonged hospitalization.

Whenever cultures have been obtained, antibiotic therapy should be appropriately focused on the organisms present. The foundations underlying appropriate antimicrobial therapy comprise timing, spectrum, and dosing. [1]  Appropriate resuscitation following known guidelines for sepsis should be instituted as soon as the diagnosis of sepsis is considered.

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