Suspected Intraabdominal Infection

Clinical Decision Algorithm
Obtain Imaging (CT with IV contrast)
Evaluate

Primary Peritonitis?

No GI source — consider SBP
Monomicrobial, no surgical source
Cefotaxime + albumin (if SBP)
5 days IV therapy
Evaluate

Secondary Peritonitis?

Clear GI source identified
Perforation or abscess evident
Empiric broad-spectrum antibiotics
Source control (surgery / drainage)
10–14 days total therapy
Evaluate

CAPD-Associated?

Peritoneal dialysis patient
Gram-positive predominant
Intraperitoneal antibiotics
14–21 days treatment
± Catheter removal

Clinical Deterioration?

Re-image with CT → identify new source or abscess
Consider tertiary peritonitis (persistent / healthcare-associated)