[Antibiotic treatment of intra-abdominal and post-surgical infections].
During the last years we observed a significant decrease of the mortality following the intra-abdominal infections thanks the improvement of surgical techniques and because of the improved approach of antibiotic treatments. The antibiotic therapy for the treatment of intra-abdominal infections greatly varies according to the infection severity. It is, in fact, possible to distinguish the intra-abdominal infections in three different categories. Mild infections should be treated promptly with surgical drainage and a short term therapy with a wide range antibiotic including anaerobes (ampicillin/sulbactam, cefoxitin). Mild-moderate infections which are largely the most frequent in the clinical practice should be also treated with a single drug which include anaerobes in its spectrum. Finally severe infections require a more aggressive therapeutic approach with a combination treatment covering anaerobes (clyndamicin, metronidazole), Gram negative rods (ciprofloxacin, aminoglycosides) and Gram positive cocci (penicillins, cephalosporins) including MRSA (glycopetides) and/or VRE (linezolid). By the surgical point of view the control of intra-abdominal infections can require different procedures such as laparatomy, relaparotomy or less frequently laparostomy (totally or partially open abdomen). A strong synergy between the surgical procedures and antibiotic therapy represents the best way to approach and resolve even the most severe intra-abdominal infections.
Sganga
G
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Dipartimento di Scienze Chirurgiche, Istituto di Clinica Chirurgica, Divisione di Chirurgia Generale e Trapianti, Universita Cattolica, Policlinico Gemelli, Roma, Italy.
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000145:classification / Q000188:drug therapy* / Q000601:surgery; D002648:Child; D004195:Disease Models, Animal; D004322:Drainage; D004359:Drug Therapy, Combination; D006801:Humans; D007813:Laparotomy; D010538:Peritonitis / Q000145:classification / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D011183:Postoperative Complications / Q000188:drug therapy* / Q000601:surgery; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D051381:Rats; D012086:Reoperation; D012307:Risk Factors; D018805:Sepsis / Q000188:drug therapy; D013997:Time Factors
D000900:Anti-Bacterial Agents