Spontaneous Bacterial Peritonitis

For Peritoneal Dialysis Related Peritonitis (click here). Please contact Specialist Nurse on Ward 7b GRH or the duty Nephrologist.

Severity
(classification)

1st line oral/iv antibiotics

Penicillin allergy
(see explanatory notes)

A/B/C

Minor to severe life threatening infection

Review doses in renal impairment

Age less than 65 years
CEFTRIAXONE 2g iv od

plus

METRONIDAZOLE 500mg iv tds


Age 65 years and older  
TEMOCILLIN 2g iv bd

plus

METRONIDAZOLE 500mg iv tds

Treatment duration: 5 - 7 days according to clinical response. Then see IV to Oral Switch below (unless lab results indicate otherwise)

Non-Severe Penicillin Allergy:
Age less than 65 years
CEFTRIAXONE 2g iv od

plus

METRONIDAZOLE 500mg iv tds

Age 65 years and older
MEROPENEM 1g iv tds


 Severe Penicillin Allergy:

TIGECYCLINE 100mg iv stat as loading, then 50mg iv bd - first maintanence dose to be given 12 hours after loading (25mg bd maintanence dose in severe hepatic disease after loading)

plus

GENTAMICIN iv (as per
local protocol)

Treatment duration: 5 - 7 days according to clinical response. Then see IV to Oral Switch below (unless lab results indicate otherwise)

IV to Oral Switch
(explanatory notes)

CO-AMOXICLAV 625mg po tds

Treatment duration: 5 - 7 days according to clinical response.

Note: Discuss need for ongoing antibiotic prophylaxis with Gastroenterologist

 

CIPROFLOXACIN 500mg po bd

plus


METRONIDAZOLE 400mg po tds

Treatment duration: 5 - 7 days according to clinical response.

Note: Discuss need for ongoing antibiotic prophylaxis with Gastroenterologist

Last reviewed: 09/05/17

For guidance on the administration of intravenous antibiotics click here
(GHNHSFT intranet)