Ticarcillin/clavulanate in the treatment of severe peritonitis.
A prospective study was performed on 50 consecutive patients with secondary peritonitis. All patients received ticarcillin/clavulanate 5.2 g three times daily as initial antibiotic therapy. In 30 patients a primary perforation was found in the gastro-intestinal tract and 20 had post-operative peritonitis. In two thirds of the patients a diffuse peritonitis was found which affected the whole abdomen. Thirty-six patients underwent one or two laparotomies and 11 patients had more than three laparotomies. Subsequently, 17 patients died. The cause of death was a therapeutic failure as a result of the surgical procedure in ten patients (nine patients with persisting intestinal fistulae, one patient with bleeding), whereas in seven cases antibiotic therapy failed. Micro-organisms found in the latter patients were producers of type 1 beta-lactamase (Pseudomonas aeruginosa, Enterobacter sp., Citrobacter sp., Serratia marcescens) and enterococci. Ticarcillin/clavulanate is characterized by its broad antimicrobial spectrum against anaerobic and aerobic bacteria and seems, therefore, to be well suited for initial chemotherapy in patients with diffuse peritonitis.
Inthorn
D
D
Department of Surgery, Klinikum Grosshadern, University of Munich, München, FRG.
Mühlbayer
D
D
Hartl
W H
WH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002969:Clavulanic Acids / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004926:Escherichia coli / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use*; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D011183:Postoperative Complications / Q000188:drug therapy; D013982:Ticarcillin / Q000627:therapeutic use*
D002969:Clavulanic Acids; D010406:Penicillins; C043215:ticarcillin-clavulanic acid; D013982:Ticarcillin