Intra-abdominal infection

Peritonitis

Primary peritonitis

• See Spontaneous bacterial peritonitis

Secondary peritonitis

• Secondary to trauma or perforation
• See also STOP IT trial for 4+/-1 days of antibiotics after source control

Tertiary peritonitis

• Ongoing intraabdominal sepsis after appropriate treatment of secondary peritonitis
• Organisms include resistant Gram-positives (Enterococcus, coagulase-negative Staphylococci), resistant Gram-negatives (ESBLs), and Candida
• Can also be aseptic without infection but with ongoing inflammation

Pyogenic Liver Abscess

• Get source control
• Treat for 4-6 weeks, ensuring radiological resolution of abscess

Further Reading

• Canadian practice guidelines for surgical intra-abdominal infections. Can J Infect Dis Med Microbiol. 2010;21(1):11–37.