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Therapeutic options in peritonitis

A B Nathens1, O D Rotstein

  • 1Department of Surgery, University of Toronto, Ontario, Canada.

The Surgical Clinics of North America
|June 1, 1994
PubMed
Summary
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Effective peritonitis management involves supportive care, antibiotics targeting gram-negative bacilli and anaerobes, and surgical source control. Patient factors guide antibiotic choice, while some methods to prevent recurrence show no benefit.

Area of Science:

  • General Surgery
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Peritonitis management requires a multi-faceted approach.
  • Antibiotic therapy and surgical intervention are key components.
  • Empiric antibiotic regimens must cover common pathogens.

Purpose of the Study:

  • To outline the fundamental principles in managing peritonitis.
  • To discuss effective antibiotic strategies and surgical interventions.
  • To evaluate methods for preventing recurrent infection.

Main Methods:

  • Review of established management principles for peritonitis.
  • Analysis of empiric antibiotic regimens for broad-spectrum coverage.
  • Description of surgical techniques for source control and peritoneal toilet.

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Main Results:

  • Effective empiric antibiotic regimens target gram-negative bacilli and anaerobes.
  • Patient-specific factors dictate antibiotic regimen selection.
  • Surgical intervention focuses on source control and peritoneal cleansing.
  • Intraoperative lavage and débridement do not prevent recurrence.

Conclusions:

  • Management hinges on supportive care, appropriate antibiotics, and surgical source control.
  • The optimal role for continuous lavage, planned relaparotomy, and laparostomy requires further study.