Bacterial Peritonitis

The prevalence of Peritonitis

The prevalence of peritonitis can vary depending on the underlying causes and populations studied. Reponex Pharmaceuticals’ peritonitis program delineates its therapeutic focus as follows:


Primary Indication: Administration for bacterial peritonitis, targeting complex abdominal infections.

Secondary Indications: Preventive measures against bacterial peritonitis.


Utilizing insights from high-impact scientific literature [1,2,3,4,5]. Reponex Pharmaceuticals, subsidiary company of Pharma Equity Group, has estimated the annual patient base for its primary indication across the US, EU, and Japan at 150.000, 300.000, and 55.000, respectively. For the secondary indication, patient estimates stand at 155.000 in the US, 430.000 in the EU, and 148.000 in Japan. 

Additionally, A study has revealed appendicitis or appendectomy rates in the 21st century at 100 cases per 100,000 person-years in Northern America, with 105 in Eastern Europe and 151 in Western Europe. Newly industrialized countries, including South Korea (206), Turkey (160), and Chile (202), showed significantly higher incidences, indicating a rapid increase in these regions compared to the stable rates observed in Western countries [6].

These figures highlight the significant potential reach of Reponex’s peritonitis treatment efforts in key markets. 

What is Peritonitis ?

Peritonitis is a Complicated intra-abdominal infection (cIAI) and causesthe inflammation of the peritoneum, the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs. The peritoneum helps support the organs and allows them to glide smoothly against each other as the body moves.

Peritonitis can be caused by various factors, such as infection, injury, or irritation. The most common cause is bacterial infection, often resulting from a rupture or perforation in the gastrointestinal tract, such as a burst appendix, a perforated stomach ulcer, or a puncture in the intestine. In some cases, peritonitis can also be a complication of abdominal surgery, where infection may occur. 

The disease manifests in three distinct forms: primary, secondary, and tertiary peritonitis, each differing in their pathogenesis, clinical presentation, and treatment strategies.

Primary Peritonitis

Primary peritonitis, also known as spontaneous bacterial peritonitis (SBP), occurs in the absence of an apparent breach in the gastrointestinal tract. It is most commonly associated with liver disease, such as cirrhosis, which leads to an accumulation of fluid in the abdomen (ascites) that becomes infected.

Secondary Peritonitis

Secondary peritonitis is the result of a direct breach in the integrity of the gastrointestinal tract, leading to the spillage of contents into the sterile abdominal cavity. Common causes include appendicitis, diverticulitis, perforated peptic ulcer, traumatic injuries, or surgical complications. It is characterized by a more severe and localized infection than primary peritonitis and requires prompt surgical intervention along with antibiotic therapy to manage the source of infection and its systemic effects.

Source: Reponex Pharmaceuticals graphics

Tertiary Peritonitis

Tertiary peritonitis represents a persistent or recurrent infection after adequate treatment for primary or secondary peritonitis. This form of peritonitis is often seen in critically ill or immunocompromised patients and is associated with a variety of pathogens, including fungi and resistant bacteria. Tertiary peritonitis requires extensive medical and surgical management, reflecting its complexity and the challenging nature of treating such infections.

Reponex Pharmaceuticals is at the forefront of developing cutting-edge treatments and prevention of secondary peritonitis, concentrating on a novel combination therapy. Our innovative solution combines the antibiodics Metronidazole and Fosfomycin, which target the broad spectrum of bacteria responsible for peritonitis, alongside GM-CSF, an immune upregulator that enhances the body’s own defense mechanisms and aids in the repair of the mucosal wall where the perforations occured. This strategic fusion not only promises to improve patient outcomes, but also addresses the complexity of infections with a multifaceted treatment strategy. Reponex’ product is therefore also believed to have a preventive potential if administered after abdominal surgery like an appendectomi, which lowers the risk for not developing secondary bacterial peritonitis. 

Rationale for developing treatment for bacterial peritonitis

The inflammation caused by peritonitis in secondary bacterial peritonitis can lead to symptoms such as severe abdominal pain, tenderness, swelling, fever, nausea, vomiting, and a general feeling of illness. Peritonitis is a serious condition that requires prompt medical attention and is typically treated with high doses of  I.V. and oral antibiotics to address the infection, as well as surgical intervention to repair the underlying cause, such as closing a perforation.  

If left untreated, peritonitis can lead to serious complications, including sepsis, multiple organ failure, and death. Therefore, it is crucial to seek medical help immediately if someone is suspected of having peritonitis. 

Our clinical approach

The treatment of peritonitis or complications which hasve high risk of leading to Pouchitis depends on the underlying cause, severity, and overall health of the individual. Peritonitis is a serious condition that often requires prompt medical attention. Here are some general aspects of peritonitis treatment and how our drug candidate RNX-011 fits in the treatment regime and is administered and left in the abdominal cavity to locally kill bacteria causing peritonitis or could potentially lead to peritonitis, minimize the chance of abscess and help re-establish the damaged mucosa. 

Our market potential

Our goal is to address the vast patient and market potential. You can learn more by watching the video below.



[1] Gessler, B., Eriksson, O., & Angenete, E. (2017). Diagnosis, treatment, and consequences of anastomotic leakage in colorectal surgery. International Journal of Colorectal Disease, 32(4), 549–556. 

[2]GlobalSurg Collaborative and National Institute for Health Research Global Health Research Unit on Global Surgery. (2021). Global variation in postoperative mortality and complications after cancer surgery: A multicentre, prospective cohort study in 82 countries. Lancet (London, England), 397(10272), 387–397. 

[3] Golz, R. A., Flum, D. R., Sanchez, S. E., Liu, X., Donovan, C., & Drake, F. T. (2020). Geographic Association Between Incidence of Acute Appendicitis and Socioeconomic Status. JAMA Surgery, 155(4), 330–338. 

[4] Lee, J. H., Park, Y. S., & Choi, J. S. (2010). The Epidemiology of Appendicitis and Appendectomy in South Korea: National Registry Data. Journal of Epidemiology, 20(2), 97–105. 

[5] Strate, L. L., & Morris, A. M. (2019). Epidemiology, Pathophysiology, and Treatment of Diverticulitis. Gastroenterology, 156(5), 1282-1298.e1. 

[6] Ferris, M., Quan, S., Kaplan, B. S., Molodecky, N., Ball, C. G., Chernoff, G. W., Bhala, N., Ghosh, S., Dixon, E., Ng, S., & Kaplan, G. G. (2017). The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies. Annals of Surgery, 266(2), 237–241.