[Antibacterial treatment in patients after extended bowel resection with ileo-cecal valve removal--personal experience].
Small bowel infection in patients that underwent extensional bowel resection is one of causal mechanisms of massive diarrhoea in postoperative period. The aim of this study was to investigate clinical importance of ciprofloxacin efficacy in treatment of massive diarrhoea in patients after extensional bowel resection with removing of ileo-coecal valve (EBR + ICVR). From group of 21 patients that underwent EBR + ICVR the postoperative period survived only 11. In 9 cases massive diarrhoea and sepsis was observed. Routinely applied three-drugs antibacterial therapy based on penicillin or first-generation cephalosporin, aminoglycoside and metronidazole was efficient in 18% of patients only. The ciprofloxacin was used as a second-shot therapy in patients which did not realt on routine three-drugs antibacterial management. In all cases the clinical efficacy was observed as recessing of diarrhoea and septic symptoms. On the basis of our experience we suggest that in patients with massive diarrhea due to ascending contamination of small bowel after extensive resection with removal of ileo-coecal valve, ciprofloxacine is the treatment of choice.
Oddział Chirurgii Ogólnej Wojewódzkiego, Jana Bozego w Lublinie.
P
P
Paluszkiewicz
M
M
Karski
M
M
Misztal
J
J
Karski
D000328:Adult; D000368:Aged; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002511:Cephalosporins / Q000008:administration & dosage; D002939:Ciprofloxacin / Q000627:therapeutic use*; D003967:Diarrhea / Q000188:drug therapy* / Q000209:etiology; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D006801:Humans; D007080:Ileocecal Valve / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D011182:Postoperative Care; D012778:Short Bowel Syndrome / Q000209:etiology; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000209:etiology
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D008795:Metronidazole; D002939:Ciprofloxacin
Leczenie przeciwbakteryjne chorych po rozległych resekcjach jelita cienkiego połaczonych z usunieciem mechanizmu zastawkowego kretniczo-katniczego--doświadczenia własne.