Abstract
Secondary peritonitis, following intestinal perforation, constitutes a significant proportion of cases admitted as a surgical emergency and has a mortality rate of 6-21% worldwide. As a part of an antimicrobial stewardship program, we noted considerable variation among the choice of empirical regimens among such cases. Hence, we conducted a prospective study to generate the evidence for a rational empiric regimen for patients with secondary peritonitis following intestinal perforation. The study included a complete follow up of 77 cases of secondary peritonitis admitted during a 12 month period. The intraoperative fluid (peritoneal) sample of the patient was sent for culture and sensitivity pattern analysis. The sites of perforation as seen in decreasing order were lower gastrointestinal (GI) (50.6%), upper GI (36.4%), and unclassified (13%). The most common organism found in the intraoperative fluid was Escherichia coli (47.9%) followed by Klebsiella pneumoniae (12.5%). amikacin, cefoperazone-sulbactam, piperacillin-tazobactam and imipenem were sensitive in 22 (out of 23 tested), 5 (out of 9), 13 (out of 13) and 22 (out of 22) isolates of E. coli and 3 (out of 6), 1 (out of 3), 4 (out of 6), 4 (out of 6) isolates of K. pneumon...Continue Reading
References
Jan 1, 1992·Archives of Surgery·J M BohnenC P Page
Nov 1, 1991·Annals of Surgery·D M MosdellD E Fry
Jan 1, 1990·Diagnostic Microbiology and Infectious Disease·R F D'AmatoH Frankel
Nov 1, 1989·Archives of Surgery·S H DoughertyP Cano
Aug 1, 1984·Postgraduate Medical Journal·A K Khanna, M K Misra
Jun 1, 1982·Critical Care Medicine·L G DonowitzJ W Hoyt
Mar 15, 2000·Annals of Tropical Paediatrics·E A Ameh
Sep 7, 2006·World Journal of Emergency Surgery : WJES·Mark A Malangoni, Tazo Inui
Sep 7, 2006·World Journal of Emergency Surgery : WJES·Rajender Singh JhobtaAnupam Jhobta
Nov 23, 2006·The Surgical Clinics of North America·Carlos A Ordoñez, Juan Carlos Puyana
Dec 26, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Joseph S SolomkinJohn G Bartlett
Jan 14, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·David R SnydmanSherwood L Gorbach
Feb 25, 2011·World Journal of Emergency Surgery : WJES·Nicole LopezRaul Coimbra
Mar 9, 2012·The Journal of Antimicrobial Chemotherapy·Benedikt HuttnerMatthew H Samore
Jan 31, 2013·Intensive Care Medicine·R P DellingerUNKNOWN Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup
Jul 5, 2013·Clinical Microbiology Reviews·Itzhak BrookEllie J C Goldstein
Jul 10, 2014·ISRN Surgery·Rajandeep Singh BaliNikhil Talwar
Jun 22, 2016·Infection·N ShafiqG Singh