Coverage of enterococci in community acquired secondary peritonitis: results of a randomized trial.
BACKGROUND
The increasing number of enterococcal infections in hospitals and reports about the development of resistance of these bacteria make it necessary to review their importance as co-pathogens in secondary peritonitis.


METHODS
A prospective randomized controlled trial on primary therapy of secondary peritonitis was carried out in six centers comparing cephalosporin-based antibiotic therapy to acylaminopenicillin-based therapy.


RESULTS
Enterococci were only cultured in 6 of 110 cases from the abdomen and were found in only 5 cases of postoperative complications. No differences were found between penicillin-based vs. cephalosporin-based therapy.


CONCLUSIONS
The study supports the view that these bacteria continue to play a minor role in secondary peritonitis. The point has to be emphasized, however, that the patients under study were in relatively good condition (APACHE II median 9 for cephalosporins and 10 for penicillins) and that postoperative cases of peritonitis were excluded.
Röhrborn
A
A
Department of General and Trauma Surgery, Heinrich Heine University, Düsseldorf, Germany.
Wacha
H
H
Schöffel
U
U
Billing
A
A
Aeberhard
P
P
Gebhard
B
B
Böcker
I
I
Schäfer
V
V
Ohmann
C
C
D000328:Adult; D000368:Aged; D002511:Cephalosporins / Q000627:therapeutic use*; D017714:Community-Acquired Infections; D013505:Digestive System Surgical Procedures / Q000379:methods; D016983:Enterococcus / Q000187:drug effects / Q000472:pathogenicity*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use*; D010538:Peritonitis / Q000188:drug therapy* / Q000601:surgery; D011183:Postoperative Complications / Q000188:drug therapy; D011446:Prospective Studies; D012086:Reoperation; D018805:Sepsis / Q000188:drug therapy* / Q000601:surgery; D013530:Surgical Wound Infection / Q000188:drug therapy*
D002511:Cephalosporins; D010406:Penicillins