{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T09:55:32Z","timestamp":1771581332802,"version":"3.50.1"},"reference-count":126,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Flanders Research Foundation","award":["1881020N"],"award-info":[{"award-number":["1881020N"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>This comprehensive review aims to provide a practical guide for intensivists, focusing on enhancing patient care associated with nosocomial peritonitis (NP). It explores the epidemiology, diagnosis, and management of NP, a significant contributor to the mortality of surgical patients worldwide. NP is, per definition, a hospital-acquired condition and a consequence of gastrointestinal surgery or a complication of other diseases. NP, one of the most prevalent causes of sepsis in surgical Intensive Care Units (ICUs), is often associated with multi-drug resistant (MDR) bacteria and high mortality rates. Early clinical suspicion and the utilization of various diagnostic tools like biomarkers and imaging are of great importance. Microbiology is often complex, with antimicrobial resistance escalating in many parts of the world. Fungal peritonitis and its risk factors, diagnostic hurdles, and effective management approaches are particularly relevant in patients with NP. Contemporary antimicrobial strategies for treating NP are discussed, including drug resistance challenges and empirical antibiotic regimens. The importance of source control in intra-abdominal infection management, including surgical and non-surgical interventions, is also emphasized. A deeper exploration into the role of open abdomen treatment as a potential option for selected patients is proposed, indicating an area for further investigation. This review underscores the need for more research to advance the best treatment strategies for NP.<\/jats:p>","DOI":"10.3390\/antibiotics12121711","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T03:03:33Z","timestamp":1702004613000},"page":"1711","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Optimized Treatment of Nosocomial Peritonitis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1017-9748","authenticated-orcid":false,"given":"Jan","family":"De Waele","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine, Ghent University Hospital, 9000 Ghent, Belgium"},{"name":"Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6364-4186","authenticated-orcid":false,"given":"Federico","family":"Coccolini","sequence":"additional","affiliation":[{"name":"General, Emergency and Trauma Surgery Department, Pisa University Hospital, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2517-8000","authenticated-orcid":false,"given":"Leonel","family":"Lagunes","sequence":"additional","affiliation":[{"name":"Vall d\u2019Hebron Institut de Recerca CRIPS, 08035 Barcelona, Spain"},{"name":"Facultad de Medicina, Universidad Aut\u00f3noma de San Luis Potosi, 78210 San Luis Potosi, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2898-7073","authenticated-orcid":false,"given":"Emilio","family":"Maseda","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, Hospital Quironsalud Valle del Henares, 28850 Madrid, Spain"},{"name":"Department of Pharmacology and Toxicology, Complutense University of Madrid, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6676-2935","authenticated-orcid":false,"given":"Stefano","family":"Rausei","sequence":"additional","affiliation":[{"name":"General Surgery Unit, Department of Surgery, Cittiglio-Angera Hospital, ASST SetteLaghi, 21100 Varese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3960-6865","authenticated-orcid":false,"given":"Ines","family":"Rubio-Perez","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit, Department of General Surgery, Hospital Universitario La Paz, 28029 Madrid, Spain"},{"name":"Hospital La Paz Institute for Health Research (Idipaz), 28029 Madrid, Spain"},{"name":"Universidad Autonoma de Madrid, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0385-1869","authenticated-orcid":false,"given":"Maria","family":"Theodorakopoulou","sequence":"additional","affiliation":[{"name":"1st Department of Critical Care Medicine & Pulmonary Services, School of Medicine, National and Kapodistrian University of Athens, Evangelismos Hospital, 10675 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1171-4108","authenticated-orcid":false,"given":"Kostoula","family":"Arvaniti","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Papageorgiou Hospital, 54646 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e034326","DOI":"10.1136\/bmjopen-2019-034326","article-title":"Global epidemiology of acute generalised peritonitis: A protocol for a systematic review and meta-analysis","volume":"10","author":"Tochie","year":"2020","journal-title":"BMJ Open"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.2165\/11599800-000000000-00000","article-title":"Essentials for selecting antimicrobial therapy for intra-abdominal infections","volume":"72","author":"Blot","year":"2012","journal-title":"Drugs"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1007\/s00134-019-05819-3","article-title":"Epidemiology of intra-abdominal infection and sepsis in critically ill patients: \u201cAbSeS\u201d, a multinational observational cohort study and ESICM Trials Group Project","volume":"45","author":"Blot","year":"2019","journal-title":"Intensive Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1089\/sur.2007.092","article-title":"Epidemiology, management, and prognosis of secondary non-postoperative peritonitis: A French prospective observational multicenter study","volume":"10","author":"Gauzit","year":"2009","journal-title":"Surg. 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