Antibiotics for the acute abdomen

The Surgical Clinics of North America
M S Farber, J H Abrams

Abstract

Antibiotics are only an adjunct to proper surgical therapy for the treatment of the acute abdomen associated with bacterial secondary peritonitis. Upon presentation, all patients require a preoperative dose of antibiotics for prophylaxis against infection of remaining sterile tissues. Patients found intraoperatively to have an established peritoneal infection benefit from an immediate postoperative course of therapeutic antibiotics. A regimen that adequately covers facultative and aerobic gram-negative bacilli and anaerobic organisms is essential. The duration of therapeutic antibiotics is probably best decided on an individual patient basis. The goal of antibiotics is to reduce the concentration of bacteria invading tissues. The pathogens of bacterial peritonitis are influenced by such factors as the patient's pre-existing chronic diseases, state of acute physiologic debilitation, immunocompetence, recent antibiotic use, recent hospitalization, and neutralization of gastric acidity. Intraoperative peritoneal cultures are most useful in patients suspected of having impaired local host defenses. In these patients, all identified organisms, such as Enterococcus or Candida, may be potential pathogens. The common practice of admini...Continue Reading

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Jan 16, 1999·Gastroenterology Clinics of North America·M S Cappell
Jan 16, 1999·Gastroenterology Clinics of North America·M S Cappell
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Apr 5, 2008·The Medical Clinics of North America·John T Langell, Sean J Mulvihill
Feb 26, 2008·British Journal of Hospital Medicine·D R C Spalding, R C N Williamson

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