Peritonitis

2. Diagnosis: Peritonitis

3. Condition:

4. Vital signs: q1-6h. Call physician if BP >160/90, <90/60; P >120, <50; R>25, <10; T >38.5°C.

5. Activity: Bed rest.

6. Nursing: Guaiac stools.

9. Special Medications:

Primary Bacterial Peritonitis -- Spontaneous: Option 1:

-Ampicillin 1-2 gm IV q 4-6h (vancomycin 1 gm IV q12h if penicillin allergic)

AND EITHER Cefotaxime (Claforan) 1-2 gm IV q6h OR Ceftizoxime (Cefizox) 1-2 gm IV q8h OR

Gentamicin or tobramycin 1.5 mg/kg IV, then 1 mg/kg q8h or 7 mg/kg in 50 mL of D5W over 60 min IV q24h. Option 2:

-Ticarcillin/clavulanate (Timentin) 3.1 gm IV q6h OR -Piperacillin/tazobactam (Zosyn) 3.375 gm IV q6h OR -Imipenem/cilastatin (Primaxin) 0.5-1.0 gm IV q6h OR -Meropenem (Merrem) 500-1000 mg IV q8h. Secondary Bacterial Peritonitis -- Abdominal Perforation or Rupture: Option 1:

-Ampicillin 1-2 gm IV q4-6h AND Gentamicin or tobramycin as above AND Metronidazole (Flagyl) 500 mg IV q8h OR Cefoxitin (Mefoxin) 1-2 gm IV q6h OR Cefotetan (Cefotan) 1-2 gm IV q12h. Option 2:

-Ticarcillin/clavulanate (Timentin) 3.1 gm IV q4-6h (200-300 mg/kg/d) with an aminoglycoside as above OR -Piperacillin/tazobactam (Zosyn) 3.375 gm IV q6h with an aminoglycoside as above OR

-Ampicillin/sulbactam (Unasyn) 1.5-3.0 gm IV q6h with aminoglycoside as above OR

-Imipenem/cilastatin (Primaxin) 0.5-1.0 gm IV q6-8h OR -Meropenem (Merrem) 500-1000 mg IV q8h.

Was this article helpful?

0 0

Post a comment