Editing Peritonitis (section)

==Treatment==
Depending on the severity of the person's state, the management of peritonitis may include:
* [[Antibiotics]] are usually administered intravenously, but they may also be infused directly into the peritoneum. The empiric choice of [[broad-spectrum antibiotics]] often consist of multiple drugs, and should be targeted against the most likely agents, depending on the cause of peritonitis (see above); once one or more agents grow in cultures isolated, therapy will be targeted against them.<ref>{{Cite book|title=Brenner and Rector's The Kidney|publisher=Elsevier|year=2020|isbn=9780323759335|edition=11th|location=Philadelphia, PA|pages=2094–2118|language=English|chapter=Peritoneal Dialysis}}</ref>
* Gram-positive and Gram-negative organisms must be covered. Out of the [[cephalosporins]], [[cefoxitin]] and [[cefotetan]] can be used to cover Gram-positive bacteria, Gram-negative bacteria, and anaerobic bacteria. Beta-lactams with beta-lactamase inhibitors can also be used; examples include [[ampicillin/sulbactam]], [[piperacillin]]/[[tazobactam]], and [[ticarcillin]]/[[clavulanate]].<ref name = "oralbetalactams">{{cite journal|url=https://www.aafp.org/afp/2000/0801/p611.html|title=Appropriate Prescribing of Oral Beta-Lactam Antibiotics|first1=Keith B.|last1=Holten|first2=Edward M.|last2=Onusko|journal=[[American Family Physician]]|date=August 1, 2000|volume=62|issue=3|pages=611–620|pmid=10950216|access-date=July 22, 2019|archive-date=June 22, 2018|archive-url=https://web.archive.org/web/20180622032415/https://www.aafp.org/afp/2000/0801/p611.html|url-status=live}}</ref> [[Carbapenems]] are also an option when treating primary peritonitis as all of the carbapenems cover Gram-positives, Gram-negatives, and anaerobes except for [[ertapenem]]. The only fluoroquinolone that can be used is moxifloxacin because this is the only fluoroquinolone that covers anaerobes. [[Tigecycline]] is a [[tetracycline]] that can be used due to its coverage of Gram-positives and Gram-negatives. Empiric therapy will often require multiple drugs from different classes.<ref>{{Cite journal|last1=Li|first1=Philip Kam-Tao|last2=Szeto|first2=Cheuk Chun|last3=Piraino|first3=Beth|last4=de Arteaga|first4=Javier|last5=Fan|first5=Stanley|last6=Figueiredo|first6=Ana E.|last7=Fish|first7=Douglas N.|last8=Goffin|first8=Eric|last9=Kim|first9=Yong-Lim|last10=Salzer|first10=William|last11=Struijk|first11=Dirk G.|date=September 2016|title=ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment|journal=Peritoneal Dialysis International |language=en|volume=36|issue=5|pages=481–508|doi=10.3747/pdi.2016.00078|issn=0896-8608|pmc=5033625|pmid=27282851}}</ref>
* Surgery ([[laparotomy]]) is needed to perform a full exploration and lavage of the [[peritoneum]], as well as to correct any gross anatomical damage that may have caused peritonitis.<ref name="titlePeritonitis: Emergencies: Merck Manual Home Edition">{{cite web |url=http://www.merck.com/mmhe/sec09/ch132/ch132g.html |title=Peritonitis: Emergencies: Merck Manual Home Edition |access-date=2007-11-25 |archive-date=2010-10-18 |archive-url=https://web.archive.org/web/20101018170935/http://www.merck.com/mmhe/sec09/ch132/ch132g.html |url-status=live }}</ref> The exception is [[spontaneous bacterial peritonitis]], which does not always benefit from surgery and may be treated with antibiotics in the first instance.