Spectrum: Local Antimicrobial Stewardship, for Island Health

1° Peritonitis Prophylaxis UGIB

Primary prophylaxis in patients with liver cirrhosis and GI bleed, with or without gastroduodenal perforation

Duration of Treatment

7 days

Empiric Therapy

Ceftriaxone 1g IV Q24H

Therapy Pearls

Use IV while NPO, then oral

For long-term secondary prophylaxis criteria, see Spontaneous Bacterial Peritonitis below

Oral Step-Down

Sulfamethoxazole/trimethoprim 1DS BID

OR

Ciprofloxacin 500mg PO BID

Long-term Prophylaxis of Spontaneous Bacterial Peritonitis

Microbiology

Usual Organisms

Enterobacteriaceae (mainly E. coli)

ESBLs in Intra-abdominal Infections