Abdominal trauma, anaerobes, and antibiotics

Thadepalli, Haragopal; Gorbach, Sherwood L.; Broido, Peter W.; Norsen, Jeanette; Nyhus, Lloyd M.

doi:10.1097/00003246-197309000-00023

Cited by 50 publications

(50 citation statements)

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“…Clindamycin shows good in vitro activity against most anaerobic bacteria and has been used successfully in the treatment of anaerobic infections (2,15,17). Recent evidence indicates that, after intravenous administration of clindamycin, blood levels of 6.2 ,g/ml are readily and consistently achieved (5).…”

Section: Methodsmentioning

confidence: 99%

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Susceptibility of Clostridium ramosum to Antimicrobial Agents

Tally

Armfield

Dowell

et al. 1974

Antimicrob Agents Chemother

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The susceptibility of 49 strains of Clostridium ramosum to 10 antibiotics was determined by agar dilution and disk diffusion tests. Results showed that, among the anaerobes, C. ramosum is second only to Bacteroides fragilis in its resistance to antimicrobial agents. All strains were susceptible to penicillin, carbenicillin, chloramphenicol, vancomycin, and metronidazole at readily achievable blood levels. Most strains (83%) were susceptible to erythromycin. There was a high level of resistance to clindamycin in 16% of the strains. All isolates were resistant to rifampin and gentamicin, and most were resistant to lincomycin. Assessment of susceptibility by measurement of inhibition zone diameters with disk diffusion tests was not satisfactory.

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Section: Methodsmentioning

confidence: 99%

“…Recently, Thadepalli et al. found C. ramosum to be the clostridial species most frequently isolated from patients with wound infections after intraabdominal trauma (17). Inadequate identification techniques account for many failures to recognize this organism.…”

mentioning

confidence: 99%

Susceptibility of Clostridium ramosum to Antimicrobial Agents

Tally

Armfield

Dowell

et al. 1974

Antimicrob Agents Chemother

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“…In cases of secondary peritonitis, empiric antibiotic regimens should at least include coverage of aerobic gram-negative bacteria in order to decrease early mortality induced by bacterial endotoxins causing septic shock; they should also include coverage of anaerobic microorganisms to prevent the development of late post-operative abscesses [10,14]. Several clinical studies performed in the 1970s showed that in the absence of adequate anti-anaerobic coverage, the late complication rate after intra-abdominal infection was high, with an incidence of post-operative abscesses of up to 30% [15,16].…”

Section: Introductionmentioning

confidence: 99%

Are there Patients with Peritonitis Who Require Empiric Therapy for Enterococcus?

Harbarth

Uçkay

2004

European Journal of Clinical Microbiology & Infectious Dise

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Enterococci are an increasingly important cause of nosocomial infections. While the clinical impact of enterococci in cases of bacteremia and super-infections in selected patient populations has been well-established, their role as primary pathogens in polymicrobial intraabdominal infections remains controversial. While it has been suggested that the presence of enterococci increases the rate of infectious post-operative complication, it has also been demonstrated that polymicrobial intra-abdominal infections involving enterococci can be treated successfully with appropriate surgical drainage and antibiotics, such as cephalosporins, that are not active against enterococci. Therefore, the question arises of whether or not antibiotic coverage against enterococci should be included in the empirical treatment of peritonitis in certain high-risk patient populations. An extensive literature review revealed some evidence arguing in favour of using empirical therapy with enterococcal coverage for intra-abdominal infections in the following cases: (i) immunocompromised patients with nosocomial, post-operative peritonitis; (ii) patients with severe sepsis of abdominal origin who have previously received cephalosporins and other broad-spectrum antibiotics selecting for Enterococcus spp.; (iii) patients with peritonitis and valvular heart disease or prosthetic intravascular material, which place them at high risk of endocarditis. The ideal therapeutic regimen for these high-risk patients remains to be determined, but empirical therapy directed against enterococci should be considered.

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“…Kislak, in a study of 40 strains of B. fragilis, showed that cephaloridine had increased activity; however, 50% of the strains were still resistant at 25 ,ug/ml (9). The clinical significance of these in vitro observations was demonstrated in a double-blind study of antimicrobial treatment in intra-abdominal sepsis following trauma (14). There was a significant increase in the isolation of anaerobes in patients treated with cephalothin compared to those receiving clindamycin.…”

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confidence: 99%

Susceptibility of Anaerobes to Cefoxitin and Other Cephalosporins

Tally

Jacobus²,

Bartlett³

et al. 1975

Antimicrob Agents Chemother

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125

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The in vitro susceptibility of 155 strains of anaerobic bacteria to five cephalosporin antibiotics was tested. Cefoxitin was the most active against 33 isolates of Bacteroides fragilis; 82% of the strains were sensitive at 16 jg/ml. At 64 yg/ml cefazolin and cephaloridine were also generally effective. Cephalothin and cephalexin were relatively inactive versus B. fragilis. Cefoxitin, cephaloridine, cefazolin, and cephalothin showed comparable activity against 122 strains of anaerobes other than B. fragilis. More than 90% of the strains were sensitive to each of these antimicrobials at 16 gg/ml. Cephalexin was the least effective cephalosporin against all species tested.

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Abdominal trauma, anaerobes, and antibiotics

Cited by 50 publications

References 0 publications

Susceptibility of Clostridium ramosum to Antimicrobial Agents

Susceptibility of Clostridium ramosum to Antimicrobial Agents

Are there Patients with Peritonitis Who Require Empiric Therapy for Enterococcus?

Susceptibility of Anaerobes to Cefoxitin and Other Cephalosporins

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