Score of Visser et al for Predicting Recurrent Fulminant Bacterial Peritonitis After Discontinuing Antibiotic Therapy

Description

Visser et al reported a score for predicting recurrent bacterial peritonitis following discontinuation of antibiotic therapy. This can help to identify a patient who may benefit from more aggressive management. The authors are from University Hospital Utrecht in The Netherlands.

Patient selection: fulminant bacterial peritonitis with open management of the abdomen

Outcome: recurrence after discontinuation of antibiotics

Parameters at time of antibiotic discontinuation:

(1) body temperature in °C

(2) leukocyte count in 10^9/L

(3) percent band cells in the differential count (from 0 to 100)

(4) cause of peritonitis

(5) duration of initial antibiotic therapy in days

(6) dependence on inotopic agents (vasopressors)

Parameter	Finding	Points
body temperature	<= 37.5°C	0
	37.6 to 38.5°C	1
	>= 38.6°C	2
leukocyte count	< 10.5 * 10^9/L	0
	10.5 to 15.5 * 10^9/L	1
	> 15.5 * 10^9/L	2
percent band cells	0 to 3%	0
	4 to 9%	1
	>= 10%	2
cause of peritonitis	perforation	0
	disruption	1
	pancreatitis	2
duration of initial antibiotic therapy	> 20 days	0
	11 to 20 days	1
	<= 10 days	2
dependent on inotroptic drugs	no	0
	yes	2

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 12

• The higher the score the greater the risk for recurrence of fulminant bacterial peritonitis after discontinuing antibiotic therapy.

Score	Recurrent Peritonitis
0 to 3	0%
4 or 5	27%
>= 6	82%

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Score of Visser et al for Predicting Recurrent Fulminant Bacterial Peritonitis After Discontinuing Antibiotic Therapy

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