Perforated or Gangrenous Appendicitis Treated With Aminoglycosides

Dougherty, Steve H.; Saltzstein, Edward C.; Peacock, Jack B.; Mercer, Leo; Cano, Pearl

doi:10.1001/archsurg.1989.01410110034006

Cited by 29 publications

(16 citation statements)

References 12 publications

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“…However, routine cultures and Gram stain of peritoneal fluid may still be obtained to allow epidemiologic tracking in the hospital to identify organisms that are recovered infrequently but may cause serious disease (e.g. Clostridium) (6). The fact that clinical investigations sometimes result in treatment failure when gram‐negative anaerobes are resistant to the antimicrobials used or when complete antimicrobial susceptibility data are not available emphasises the need for accurate and early knowledge of the bacteriologic characteristic of the flora of the operative site (7).…”

Section: Discussionmentioning

confidence: 99%

Value of intraoperative abdominal cavity culture in appendicectomy: a retrospective study

Moawad

DASMOHAPATRA

Justin

et al. 2006

International Journal of Clinical Practice

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Appendicectomy is one of the most common surgical emergency procedures. Intraperitoneal culture during appendicectomy is routine practice in some hospitals, while some surgeons advocate abandoning this routine. The aim of our study is to determine the value of intraoperative abdominal cavity culture and its impact on the patient management. Retrospective analysis was performed on 498 patients who underwent appendicectomy over 2.5-year period. The median of the postoperative hospital stay was 2 days, while the median time taken to receive culture results was 3 days. A positive culture was found in 42.6%. Approximately 42.7% of the patients were discharged from the hospital before receiving the culture results. The culture and sensitivity results altered the antibiotic regimen in one patient (0.85%). Intraoperative abdominal cavity culture results were seldom used for clinical management in patients with acute appendicitis. The traditional surgical practice of routinely culturing peritoneal fluid in these patients should be abandoned.

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Section: Discussionmentioning

confidence: 99%

Value of intraoperative abdominal cavity culture in appendicectomy: a retrospective study

Moawad

DASMOHAPATRA

Justin

et al. 2006

International Journal of Clinical Practice

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“…17 In a retrospective survey of 480 patients with secondary bacterial peritonitis, Mosdell et al 18 reported only 68% of peritoneal sampling and noted that surgeons typically ignored culture data, as 9% of patients in this study had an appropriate change in antibiotic treatment after operation. Similarly, in complicated appendicitis, Dougherty et al 19 noted that culture reports influenced antimicrobial therapy for only 7% of patients. In our study, technical problems raised by the limited availability of the microbiology laboratory in several institutions, and consequently the poor reliability of negative results, could have led clinicians to avoid microbiological sampling and to maintain their initial prescriptions.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Therapeutic Features of Nonpostoperative Nosocomial Intra-abdominal Infections

Montravers¹,

Chalfine²,

Gauzit³

et al. 2004

Annals of Surgery

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Delayed diagnosis and increased severity are the main characteristics of non-PostopNAI infections. Microbiological features are quite similar in CAI and non-PostopNAI infections, suggesting that antibiotic therapy recommended for CAI infections could be applied to non-PostopNAI patients. Characteristics of non-PostopNAI patients should lead to identify them as a specific entity in clinical trials.

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“…Escherichia coli is the most commonly isolated Gram-negative bacteria, whereas Bacteroides tops the list among the anaerobes. 12–14 The empiric therapy used is a combination of aminoglycoside with clindamycin or metronidazole in the western world. Monotherapy with cefoxitin or ampicillin has also been used with good results.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial susceptibility patterns of organisms causing secondary abdominal infections in patients with perforated abdominal viscus

Kumar‐M

Shafiq

Kumar

et al. 2019

Therapeutic Advances in Infection

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Background: 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. Methods: 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. Results: 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. pneumoniae, respectively. The most common empirical antibiotic was cefoperazone-sulbactam (38.7%) followed by piperacillin-tazobactam (29.3%). Conclusion: Based on our prospective study, piperacillin-tazobactam or imipenem should be used empirically in patients presenting with complicated intra-abdominal infections secondary to perforated viscus, especially if they have sepsis or septic shock.

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Perforated or Gangrenous Appendicitis Treated With Aminoglycosides

Cited by 29 publications

References 12 publications

Value of intraoperative abdominal cavity culture in appendicectomy: a retrospective study

Value of intraoperative abdominal cavity culture in appendicectomy: a retrospective study

Clinical and Therapeutic Features of Nonpostoperative Nosocomial Intra-abdominal Infections

Antimicrobial susceptibility patterns of organisms causing secondary abdominal infections in patients with perforated abdominal viscus

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