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ABD 6.2 Peritonitis - secondary to perforation

Content version
U-269.2
Updated
10/20/2025 - 13:38

Recommendations

≥ 18 years
Dosage Remarks
piperacillin/tazobactam IV continuous infusion per 24 hours for 5 days

or

piperacillin/tazobactam IV 4000/500 mg 4 times daily for 5 days

Dosing for continuous infusion:

First administer a loading dose of 4000/500 mg over 30 minutes, then 16000/2000 mg continuous infusion per 24 hours.
≥ 18 years

Contraindications: Allergy to penicillins*
Dosage Remarks
cefuroxime IV 1500 mg 3 times daily

+

metronidazole PO 500 mg 3 times daily

+

amikacin IV 20 mg/kg single dose

non-IgE-mediated penicillin allergy

amikacin until culture results are known

Comments

*See protocol Policy for antibiotic allergy | Radboud UMC

Duration depends on the clinical situation. There is evidence that 4 days of antibiotic treatment after achieving source control is sufficient (Sawyer et al. NEJM 2015)