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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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