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Does intake of Gentamycin help in curing peritonitis?

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Posted on Fri, 15 Apr 2016
Question: Hello Doctor, is gentamicin the preferred IV antibiotics for peritonitis.
doctor
Answered by Dr. Prakash H Muddegowda (1 hour later)
Brief Answer:
Yes, it is.

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:

1. Yes, Gentamycin is one of the commonly prescribed medication for serious infection and peritonitis definitely is a serious condition.
2. In suspected resistant bacterial infection, it is definitely my choice.
3. If the kidney function is affected, dosage adjustments will be necessary. Otherwise, it is to be started.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Prakash H Muddegowda (1 hour later)
Thank you Doctor, can you please advise me how would you test to see if in fact the Gentamycin was effective in treating the serious infection as periitonitis is known to be assuming the patient does not speak english or is unable to communicate.
doctor
Answered by Dr. Prakash H Muddegowda (2 hours later)
Brief Answer:
Need to look into clinical signs of improvement and patient comfort

Detailed Answer:
Hi,
Thanks for asking again.
Based on your query, my opinion is as follows:

1. Main would be to watch for clinical improvement.
2. I would first look for temperature, pulse rate, blood pressure and respiratory rate, if they all come back to normal, then gentamycin is working. However, it would take at least 2-3 days for gentamycin to act against infection.
3. Along with it, i will look for regular urine and stools. If they are good and there is no abdominal discomfort, it will mean, patient is recovering.

Need to wait for at least 2-3 days to look for effectiveness of gentamycin.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Prakash H Muddegowda (19 hours later)
Thank you Dr XXXXXXX .the abdomen is distended and has been for a few days and the CRP is 315, esr 45, neutrophils 24, wcc 26 and Albumin down to 17..found a small blot clot from behind..so now on gentymycin as not sure where infection is..also.has a fistula removed and high anterior resection division of adhesions and pelvic absess drain 3 years ago...legs are swelling now and on NO medications.
doctor
Answered by Dr. Prakash H Muddegowda (11 hours later)
Brief Answer:
Raised ESR, CRP indicates infection

Detailed Answer:
Hi,
Thanks for replying.

1. Raised ESR, WBC count, and CRP indicates ongoing, possible chronic inflammation.

2. Without identification, difficult to treat. Distension of abdomen, gives possible cause. Previous history of abdominal surgery gives possibly abdomen as the cause. Main reason she is on Gentamycin.

3. Leg swelling is due to rest and vein pressure impeding venous return. It will reduce with movement, as she improves.

Hope it works and CRP level reduces.
Improved nutrition essential.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Prakash H Muddegowda (10 hours later)
Thank You Dr XXXXXXX please find attached 3 month old UTI results ...as there is no improvement with the Gentamycin I was hoping if you can advise me ..Three months ago due to a ecoli growth Gentamycin was not given as the susceptibility test confirmed resistant. Should i advise my doctor of this and change the type of antibiotics to something else.
doctor
Answered by Dr. Prakash H Muddegowda (1 hour later)
Brief Answer:
Can inform doctor, different infection and organisms probably now

Detailed Answer:
Hi,
Thanks for replying again.
I went through the attached reports and based on your query, my opinion is as follows;

1. E.coli is usually a very antibiotic resistant infection and that is the main reason, sensitivity tests for antibiotics are usually advised in urine infection.
2. At present, there is no Urinary tract infection or any symptoms of UTI, I presume. Abdominal infection is rarely due to E.coli and more commonly due to pseudomonas and other organisms, which can be sensitive for treatment with Gentamycin.
3. Earlier, it was treated and patient had recovered. Now it is different infection and even if organism is same, it could be sensitive. However, nothing wrong in giving information about treatment history to doctor as it could help in management, if they are suspecting something.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Prakash H Muddegowda (34 hours later)
Thank you Dr XXXXXXX . its look like IV Keflin is being used instead of Gentamycin...i was always of the beleif that Gentamycin is a far more effective antibiotics for a severe peritonitis ..can you advise me about keflin as I prefer Gentamycin.
doctor
Answered by Dr. Prakash H Muddegowda (2 hours later)
Brief Answer:
More than 3 days, not improving, organism might be resistant to gentamycin

Detailed Answer:
Hi,
Thanks for asking again.

1. It has been more than 3 days since gentamycin was probably started. If it were to be functioning, and sensitive to infection, the symptoms would have improved. It appears gauging by your doctors changing the antibiotic, gentamycin is probably not working.
2. Keflin is useful in serious infection, especially with susceptible organism. If gentamycin is not working, no use wasting time delaying treatment and causing toxicity to liver and kidney. Better would be to change it.
3. Keflin is active against enteric bacteria, where infection is suspected at present. It could probably work, and again 3 days, need to watch for improvement to exactly gauge its sensitivity to fight infection at present. Unless the infection is identified, it will be always trying numerous medications.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prakash H Muddegowda (12 hours later)
Dr XXXXXXX if a 160 mg of IV Gentymicin. was pescribed .would there be enough in one bottle to.last over 2 days or would the iv container that hold the liquid on the metal syand be replaced every 6 hours or is it one dose over 48 to 72 hours.

And can you combine it with keflin...sorry 2 two questions..i just want to understand this as I am concise in nature.
doctor
Answered by Dr. Prakash H Muddegowda (32 minutes later)
Brief Answer:
Needs to be replaced every eight hours

Detailed Answer:
Hi,
Thanks for asking again.
Based on your query, my opinion is as follows:

1. 160 mg is the minimum dose necessary every eight hours, assuming the patient weighs around 50 kg (3-5 mg/kg 8 hourly). Same one cannot be continuously used for 2 days.
2. It needs to be replaced from the metal stand every eight hours. It needs to be given within 30 minutes, once it is started.
3. Keflin can be given separately and both can be used together, if necessary.. However, it cannot be combined in the same container.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prakash H Muddegowda (23 minutes later)
Dr XXXXXXX does think photo look like peritonitis or a bursted diverticulum with mucus and diarrhea or just diverticulitis...what would be your suspicion or concern here with this photo.
doctor
Answered by Dr. Prakash H Muddegowda (2 hours later)
Brief Answer:
Peritonitis doubtful, could be diverticulitis

Detailed Answer:
Hi,
Thanks for asking.
Based on your query and attached report, my opinion is as follows:

1. Peritonitis is difficult without any ultrasound or biopsy finding. Clinically, severe pain abdomen could be seen. Discharge is seen only when there is an open wound.
2. Diverticulitis can present with blood and mucus. Again, burst diverticulitis diagnosis is not possible based on discharge.
3. Here, looking at image, if it is from rectum, it could be diverticulitis and not peritonitis. If not from rectum, bed already needs to be ruled out.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Prakash H Muddegowda

Geriatrics Specialist

Practicing since :2004

Answered : 2138 Questions

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Does intake of Gentamycin help in curing peritonitis?

Brief Answer: Yes, it is. Detailed Answer: Hi, Thanks for asking. I am Dr. Prakash HM and I will be answering your query. Based on your query, my opinion is as follows: 1. Yes, Gentamycin is one of the commonly prescribed medication for serious infection and peritonitis definitely is a serious condition. 2. In suspected resistant bacterial infection, it is definitely my choice. 3. If the kidney function is affected, dosage adjustments will be necessary. Otherwise, it is to be started. Hope it helps. Any further queries, here to help again. Dr. Prakash HM