Infective complications according to duration of antibiotic treatment in acute abdomen.
BACKGROUND
Adjuvant antibiotic therapy for acute abdominal conditions is widely used. Its timing, duration, dose and spectrum, however, are not homogeneous amongst surgeons and prolonged courses are often used despite the unproven benefits of this practice.


OBJECTIVE
To evaluate use and compare duration of antibiotic treatments in acute abdominal surgery.


METHODS
Retrospective cohort study. The medical records of 290 patients who underwent operations for acute abdomen from July 1998 to July 1999 in a teaching hospital were reviewed. The pattern of antibiotic use and rates of postoperative complications were evaluated, along with surgical diagnosis, degree of contamination/infection, and incidence of postoperative complications. The patients were stratified according to the degree of contamination/infection noted during the operation. The study population was divided in two groups according to the duration of antibiotic use (cut-off point at the median antibiotic use in days, for each group of contamination/infection degree), and outcomes were compared.


RESULTS
The degree of contamination/infection was significantly associated with an increased risk of wound infection, intra-abdominal abscess, postoperative infective complications and overall postoperative complications (p < 0.001). A long course of antibiotics was not associated with lower infective complication rates.


CONCLUSIONS
Shorter courses of antibiotic therapy based on the degree of contamination/infection seem to be safe. A prospective study should confirm this hypothesis.
Gleisner
Ana L M
AL
General Surgery Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. luiza@via-rs.net
Argenta
Rodrigo
R
Pimentel
Marcelo
M
Simon
Tatiana K
TK
Jungblut
Carlos F
CF
Petteffi
Leonardo
L
de Souza
Rafael M
RM
Sauerssig
Mauricio
M
Kruel
Cleber D P
CD
Machado
Adão R L
AR
D000006:Abdomen, Acute / Q000601:surgery*; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001064:Appendicitis; D001424:Bacterial Infections / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013530:Surgical Wound Infection / Q000517:prevention & control
D000900:Anti-Bacterial Agents