[Microbiology and antibiotic treatment of the abdominal gunshot injury].
Abdominal gunshot injury is a life-threatening condition and requires urgent and complex measures in its management: control of the hemorrhage and the source of infection through a surgical intervention; prophylaxis and antibiotic therapy of the infectious complications; intensive care for cardiology and pulmonary support. Development of the first phase in infection process (diffuse peritonitis and bacteraemia), according to the contemporary knowledge, is governed by Esherichia coli, Enterococcus spp, Bacteroides fragilis group, which produce a variety of virulence factors: cell organelles, enzymes and toxins, while the significance of anaerobes is well defined in the second phase (development of abscess). The time since the incidence has been regarded as crucial for application of antibiotic therapy or prophylaxis: if the time is < 4 hours and the score according APACHE-, ATI-, or other scoring system is low, the case is considered as a contaminated procedure and an antibiotic prophylaxis is suitable. In case of longer period (> 4 hours) and objective data for severe injury, the antibiotic therapy should be applied. Even the first empirically prescribed antibiotic therapy should be appropriate: it should cover both the possible pathogens and should be prescribed in appropriate dosage regimen.
Kirov
G
G
K'oleian
E
E
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D006801:Humans; D014946:Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D014948:Wounds, Gunshot / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents