Spectrum: Local Antimicrobial Stewardship, for UCLA Health

Secondary Peritonitis/GI Perforation

Antifungal Therapy

Empiric antifungal therapy is generally NOT indicated for GI perforation unless patient has one of the following risk factors:

  •  Esophageal perforation,

  •  Immunosuppression

  •  Prolonged antacid therapy

  • Prolonged antibiotic therapy

  •  Prolonged hospitalization

  •  Persistent GI leak

Initial Empiric Therapy

Fluconazole 400 mg IV/PO q24h*

*Clinically stable patients without prior long-term azole therapy.

OR

Caspofungin 70 mg IV x 1,
Then 50 mg IV q24h*

*Patients who are clinically unstable or have received prior long-term azole therapy.