Peritonitis primary prevention

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Peritonitis Main Page

Patient Information

Overview

Causes

Classification

Spontaneous Bacterial Peritonitis
Secondary Peritonitis

Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]

Overview

Primary Prevention

Prevention depends on the cause and the specific type of peritonitis.

  • A 2012 guideline from the American Association for the Study of Liver Diseases recommends( chronic antibiotic prophylaxis with a regimen )for patients who are at highest risk for PBP including:
    • Those with an ascitic-fluid total protein level <1.5 g/dL +
    • Patients with impaired renal function
      • Blood urea nitrogen (BUN) ≥25 mg/dL serum sodium, ≤130 mg/dL)
      • Serum.creatinine ≥1.2 mg/dL
      • Serum.sodium ≤130 mg/dL) and/or
    • Liver failure
      • Child-Pugh score ≥9 and
      • Bilirubin ≥3 mg/dL)
  • For patients with cirrhosis and gastrointestinal bleeding:
      • A 7-day course of antibiotic prophylaxis is recommended.
Primary peritonitis Secondary peritonitis Tertiary peritonitis
  • Spontaneous peritonitis: Patients with peritoneal catheters should be treated with sterile techniques. In cases of liver failure, antibiotics may help prevent peritonitis from coming back.
  • Dialysis associated peritonitis: Careful sterile technique when performing peritoneal dialysis may help reduce the risk of inadvertently introducing bacteria during the procedure. Some cases are not preventable. Equipment design improvements have made these infections less common.

References

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