Pattern of antibiotic therapy and clinical outcome in acute generalized peritonitis in semi-urban and rural Nigerians.
To determine the pattern of antibiotic therapy and clinical outcome a prospective survey of all patients operated on for acute generalized peritonitis was undertaken. The male to female ratio was 1.7:1, and the mean age was 27.6 +/- 18.3 years. Operative findings were typhoid ilea perforation in 75 (38.1%), complicated acute intestinal obstruction in 44 (22.3%), complicated and uncomplicated acute appendicitis in 34 (17.3%), peptic ulcer perforation in 18 (9%) and traumatic intestinal injury in 11 (5.6%), representing the majority of the patients. A combination of chloramphenicol, gentamicin and metronidazole was given to 80 (40.6%), ampiclox, gentamicin and metronidazole to 72 (36.5%), ampiclox and gentamicin to 21 (10.6%) and other combinations to 5. A single antibiotic was administered in 13 (6.6%), that is clavulanate-amoxicillin, ampiclox, and cefuroxime. Antibiotics were changed in 37 patients (18.8%): to amoxicillin-clavulanate in 13, cefuroxime in 11, ceftriazone in 7, cefuroxime and metronidazole in 4 and amoxicillin-clavulanate and metronidazole in 2 patients. Postoperative complications were mainly wound infection in 105 (42.6%), wound dehiscence in 33 (16.7%), residual intra-abdominal sepsis in 19 (9.6%), residual intra-abdominal abscess in 17 (8.6%), postoperative chest infection in 14 (7%), incisional hernia in 11 (5.6%), anaemia in 6, faecal fistula in 5 and there was a mortality of 15.7%.
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria. adesunkanmi@yahoo.com
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Adesunkanmi
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Badmus
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010538:Peritonitis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000178:diet therapy*; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012424:Rural Population; D016896:Treatment Outcome; D014505:Urban Population
D000900:Anti-Bacterial Agents