[Is penicillin G the drug of choice in gas gangrene? Results of a prospective documentation of clinical, microbiological and animal experiment data].
Between 1978 and 1990 98 patients with gas gangrene were treated in the departments of general surgery and traumatology of the University of Kiel. The microbiological results of tissue samples and results of animal infectious experiments were correlated to the clinical outcome. It could be shown, that gas gangrene due to C.perfringens alone had a higher mortality than gas gangrene due to polymicrobial infection. In trauma patients, however, the rate of amputations was lower in cases of clostridial monoinfections (25%), than in patients with mixed infections (48%). The results of animal experiments with guinea pigs which were infected by patients' infectious material showed a correlation to the clinical outcome. This correlation could not bee shown using isolated and cultured clostridia. Therefore and because of the quantity of mixed infections it is necessary to use broad spectrum antibiotics for treatment in cases of gas gangrene and for perioperative antibiotic prophylaxis. Penicillin-G alone can not more be recommended for this purpose.
Erttmann
M
M
Chirurgische Universitätsklinik, Abteilung Unfallchirurgie, Kiel.
Hobrecht
R
R
Havemann
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D005738:Gas Gangrene / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D006168:Guinea Pigs; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009104:Multiple Trauma / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D010400:Penicillin G / Q000009:adverse effects / Q000627:therapeutic use*; D015163:Superinfection / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D015996:Survival Rate
D010400:Penicillin G
Ist Penicillin-G das Mittel der Wahl beim Gasödem? Ergebnisse aus prospektiver Dokumentation klinischer, mikrobiologischer und tierexperimenteller Daten.