Gouin F, Raybaud F, Auffray J P, Viard L
Ann Anesthesiol Fr. 1978;19(11-12):915-8.
The selection depends on several factors and in particular: -the means of transport by which the antibiotic reaches the peritoneum : the aminosides and the betalactamines attain the peritoneum easily while the polymyxins do not; -the causative agent: most often it is a gram negative aerobic or anaerobic bacteria. The entero-bacteria predominate but in the last few years Bacteroides fragilis has been frequently encountered giving rise to numerous studies. The flora is most often polymicrobic. The betalactamines act on gram positive bacteria whether they are aerobic or anaerobic. The aminosides are active against aerobic gram negative bacteria. The same can be said for Colimycine (except for certain Proteus and Providencia). All these antibiotics (other than carbenicillin) are not effective against Bacteroides fragilis which are however very sensitive to lincomycine, to the cyclines and in particular to doxycycline and to the derivatives of imidazole. The laboratory is an important aid in judging therapeutic effectiveness by determining the bacteriacidal strength of the serum and even the serum level of the antibiotic whatever the cause it is imperative: to avoid toxicity and to pay particular attention to the frequent problem of renal insufficiency in these subjects.
选择取决于几个因素，尤其是：抗生素到达腹膜的运输方式：氨基糖苷类和β-内酰胺类抗生素很容易到达腹膜，而多粘菌素则不然；病原体：大多数情况下是革兰氏阴性需氧菌或厌氧菌。肠杆菌占主导地位，但在过去几年中，脆弱拟杆菌经常出现，引发了大量研究。菌群通常是多种微生物的。β-内酰胺类抗生素对革兰氏阳性菌有效，无论它们是需氧菌还是厌氧菌。氨基糖苷类抗生素对需氧革兰氏阴性菌有活性。粘菌素也是如此（某些变形杆菌和普罗威登斯菌除外）。所有这些抗生素（除羧苄青霉素外）对脆弱拟杆菌均无效，但脆弱拟杆菌对林可霉素、四环素类，尤其是强力霉素和咪唑衍生物非常敏感。实验室通过测定血清的杀菌强度甚至抗生素的血清水平，在判断治疗效果方面是一项重要的辅助手段，无论病因如何，都必须：避免毒性，并特别注意这些患者中常见的肾功能不全问题。
