Antimicrobial Therapy of Intra-Abdominal Infections (According to the guidelines of Surgical Infection Society) | CMAC

Antimicrobial Therapy of Intra-Abdominal Infections (According to the guidelines of Surgical Infection Society)

Clinical Microbiology and Antimicrobial Chemotherapy. 2003; 5(2):153-166

​ Efimenko N.A., Bazarov A.S.
abdominal surgery intra-abdominal infections antimicrobial therapy guidelines
Section
Guidelines
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2003; 5(2):153-166

Abstract

Treatment of intra-abdominal infections (IAI) is а significant problem in surgery. Taking into consideration the clinical practice in Russia, this paper presents an analysis of guidelines on antimicrobial therapy for IAI, developed by Surgical Infection Society and published in 2002. The main issues of antimicrobial therapy of IAI, such as patient selection and optimal duration of antimicrobial therapy are considered. Recommended their antimicrobial agents and combinations for treatment of IAI, which were shown in large number of prospective controlled trials to have high clinical efficacy, are listed. Risk factors for treatment failure and death in patients with IAI are identified. Choice of antimicrobials in higher-risk patients is provided as well. Relevant areas for future investigations, focusing on improving antimicrobial therapy of IAI, are presented.

  • 1. Mazuski J.E., Sawyer R.G., NathensA.B., et al. The Surgical InfectionSociety guidelines on antimicrobialtherapy for intra-abdominal infec-tions: evidence for the recommen-dations. Surg Infect 2002;3:175-233.
  • 2. Bohnen J.M.A., Solomkin J.S.,Dellinger E.P., et al. Guidelines forclinical care: anti-infective agentsfor intraabdominal infection. ASurgical Infection Society policystatement. Arch Surg 1992;127:83-9.
  • 3. Ерюхин И.А., Гельфанд Б.Р.,Шляпников С.А. Хирургическиеинфекции. Руководство. СПб:Питер; 2003. с. 864.
  • 4. Fabian T.C., Croce M.A., Pay-ne L.W., et al. Duration of antibio-tic therapy for penetrating abdomi-nal trauma: a prospective trial.Surgery 1992;112:788-95.
  • 5. Bozorgzadeh A., Pizzi W.F., Ba-rie P.S., et al. The duration ofantibiotic administration in pene-trating abdominal trauma. Am JSurg 1999;177:125-31.
  • 6. Kirton O.C., O’Neill P.A., Kest-ner M., et al. Perioperative antibio-tic use in high-risk penetrating hol-low viscus injury: a prospective ran-domized, double-blind, placebo-control trial of 24 hours versus 5days. J Trauma 2000;49:822-32.
  • 7. Schein M., Assalia A., Bachus H.Minimal antibiotic therapy afteremergency abdominal surgery: aprospective study. Br J Surg1994;81:989-91.
  • 8. Andaker L., Hojer H., Kihlstrom E.,et al. Stratified duration of prophy-lactic antimicrobial treatment inemergency abdominal surgery.Metronidazole–fosfomycinvs.metronidazole–gentamicin in 381patients. Acta Chir Scand 1987;153:185-92.
  • 9. Ефименко Н.А. и др. Антибиоти-копрофилактика и антибиотико-терапия основных форм хирурги-ческих инфекций. Методическиерекомендации ГВМУ МО РФ.Москва; 2002.
  • 10. Wittmann D.H., Schein M. Let usshorten antibiotic prophylaxis andtherapy in surgery. Am J Surg1996;172:26S–32S.
  • 11. Lennard E.S., Minshew B.H.,Dellinger E.P., et al. Leukocytosisat termination of antibiotic thera-py: its importance for intra-abdom-inal sepsis. Arch Surg 1980;115:918-21.
  • 12. Lennard E.S., Dellinger E.P., WertzM.J., et al. Implications of leukocy-tosis and fever at conclusion ofantibiotic therapy for intra-abdo-minal sepsis. Ann Surg 1982;195:19-24.
  • 13. Smith J.A., Bell G.A., Murphy J., etal. Evaluation of the use of a proto-col in the antimicrobial treatmentof intra-abdominal sepsis. J HospInfect 1985;6:60-4.
  • 14. Taylor E., Dev V., Shah D., et al.Complicated appendicitis: is there aminimum intravenous antibioticrequirement? A prospective ran-domized trial. Am Surg 2000;66:887-90.
  • 15. Visser M.R., Bosscha K., Olsman J.,et al. Predictors of recurrence offulminant bacterial peritonitis afterdiscontinuation of antibiotics inopen management of the abdomen.Eur J Surg 1998;164:825-9.
  • 16. Solomkin J.S., Reinhart H.H., Del-linger E.P., et al. Results of a ran-domized trial comparing sequentialintravenous/oral treatment withciprofloxacin plus metronidazole toimipenem/cilastatin for intra-abdominal infections. Ann Surg1996;223:303-15.
  • 17. Yoshioka K., Youngs D.J., Keigh-ley M.R. A randomized prospectivecontrolled study of ciprofloxacinwith metronidazole versus amoxi-cillin/clavulanic acid with metroni-dazole in the treatment of intra-abdominal infection. Infection1991;19:25-9.
  • 18. Donahue P.E., Smith D.L., Yel-lin A.E., et al. Trovafloxacin in thetreatment of intra-abdominal infec-tions: results of a double-blind,multicenter comparison withimipenem/cilastatin. Am J Surg1998; 176(Suppl 6A):53S-61S.
  • 19. Cohn S.M., Lipsett P.A., Buch-man T.G., et al. Comparison ofintravenous/oral ciprofloxacin plusmetronidazole versus piperacil-lin/tazobactam in the treatment ofcomplicated intraabdominal infec-tions. Ann Surg 2000;232:254-6.
  • 20. Solomkin J.S., Dellinger E.P.,Christou N.V., et al. Results of amulticenter trial comparingimipenem/cilastatin to tobramy-cin/clindamycin for intra-abdomi-nal infections. Ann Surg1990;212:581-91.
  • 21. Hatala R., Dinh T., Cook D.J.Once-daily aminoglycoside dosingin immunocompetent adults: ametaanalysis. Ann Intern Med1996;124:717-25.
  • 22. Hollender L.F., Bahnini J., DeManzini N., et al. A multicentricstudy of netilmicin once daily ver-sus thrice daily in patients withappendicitis and other intra-abdominal infections. J AntimicrobChemother 1989;23:773-83.
  • 23. de Vries P.J., Verkooyen R.P.,Leguit P., et al. Prospective ran-domized study of once-daily versusthrice daily netilmicin regimens inpatients with intraabdominal infec-tions. Eur J Clin Microbiol InfectDis 1990;9:161-8.
  • 24. Yellin A.E., Heseltine P.N.R., Ber-ne T.V., et al. The role ofPseudomonasspecies in patientstreated with ampicillin and sulbac-tam for gangrenous and perforatedappendicitis. Surg Gynecol Obstet1985;161:303–7.
  • 25. Study Group of IntraabdominalInfections. A randomized con-trolled trial of ampicillin plus sul-bactam vs. gentamicin plus clin-damycin in the treatment ofintraabdominal infections. A pre-liminary report. Rev Infect Dis1986;8:S583-8.
  • 26. Poenaru D., De Santis M., ChristouN.V.Imipenemversustobramycin–antianaerobe antibiot-ic therapy in intra-abdominal infec-tions. Can J Surg 1990;33:415-22.
  • 27. Paakkonen M., Alhava E.M.,Huttunen R., et al. Piperacillincompared with cefuroxime plusmetronidazole in diffuse peritonitis.Eur J Surg 1991;157:535-7.
  • 28. Sirinek K.R., Levine B.A. A ran-domized trial of ticarcillin andclavulanate versus gentamicin andclindamycin in patients with com-plicated appendicitis. Surg GynecolObstet 1991;172(Suppl):30-5.
  • 29. Eckhauser F.E., Knol J.A., Ra-per S.E., et al. Efficacy of two com-parative antibiotic regimens in thetreatment of serious intra-abdomi-nal infections: results of a multicen-ter study. Clin Ther 1992;14:97-109.
  • 30. De Groot H.G., Hustinx P.A.,Lampe A.S., et al. Comparison ofimipenem/cilastatin with the com-bination of aztreonam and clin-damycin in the treatment of intra-abdominal infections. J AntimicrobChemother 1993;32:491-500.
  • 31. Polk H.C. Jr., Fink M.P., Laver-diere M., et al. Prospective random-ized study of piperacillin/tazobac-tam therapy of surgically treatedintra-abdominal infection. Am Surg1993;59:598-605.
  • 32. Walker A.P., Nichols R.L., Wil-son R.F., et al. Efficacy of a beta-lactamase inhibitor combination forserious intra-abdominal infections.Ann Surg 1993;217:115-21.
  • 33. Condon R.E., Walker A.P., Siri-nek K.R., et al. Meropenem versustobramycin plus clindamycin fortreatment of intraabdominal infec-tions: results of a prospective, ran-domized, double-blind clinical trial.Clin Infect Dis 1995;21:544-50.
  • 34. Huizinga W.K.J., Warren B.L.,Baker L.W., et al. Antibioticmonotherapy with meropenem inthe surgical management of intra-abdominal infections. J AntimicrobChemother 1995;36(Suppl A):179-89.
  • 35. Shyr Y.M., Lui W.Y., Su C.H., et al.Piperacillin/tazobactam in compa-rison with clindamycin plus gen-tamicin in the treatment of intra-abdominal infections. Chung Hua IHsueh Tsa Chih-Chinese Med J1995;56:102-8.
  • 36. Angeras M.H., Darle N., Hamnst-rom K., et al. A comparison ofimipenem/cilastatin with the com-bination of cefuroxime and metron-idazole in the treatment of intra-abdominal infections. Scand JInfect Dis 1996;28:513-8.
  • 37. Berne T.V., Yellin A.E., Apple-man M.D., et al. Meropenem versustobramycin with clindamycin inthe antibiotic management ofpatients with advanced appendici-tis. J Am Coll Surg 1996;182:403-7.
  • 38. Christou N.V., Turgeon P., Was-sef R., et al. Management of intra-abdominal infections. The case forintraoperative cultures and com-prehensive broad-spectrum anti-biotic coverage. Arch Surg 1996;131:1193-201.
  • 39. Barie P.S., Vogel S.B., Dellin-ger E.P., et al. A randomized, dou-ble-blind clinical trial comparingcefepime plus metronidazole withimipenem–cilastatin in the treat-ment of complicated intra-abdomi-nal infections. Arch Surg 1997;132:1294-302.
  • 40. Kempf P., Bauernfeind A., Mul-ler A., et al. Meropenem monothe-rapy versus cefotaxime plusmetronidazole combination treat-ment for serious intra-abdominalinfections. Infection 1996;24:473-9.
  • 41. Wilson S.E. Results of randomized,multicenter trial of meropenem ver-sus clindamycin/tobramycin forthe treatment of intra-abdominalinfections. Clin Infect Dis1997;24(Suppl 2):S197–S206.
  • 42. Ohlin B., Cederberg A., Forssell H.,et al. Piperacillin/tazobactam com-pared with cefuroxime/metronida-zole in the treatment of intra-abdominal infections. Eur J Surg1999;165:875-84.
  • 43. Rohrborn A., Wacha H., Schof-fel U., et al. Coverage of enterococ-ci in community-acquired sec-ondary peritonitis: results of a ran-domized trial. Surg Infect2000;1:95-107.
  • 44. Solomkin J.S., Yellin E., Rot-stein O.D., et al. Results of a dou-ble-blind, randomized comparativephase III trial of ertapenem vs.piperacillin/tazobactam in thetreatment of complicated intra-abdominal infections. Ann Surg (inpress).
  • 45. Гельфанд Б.Р., Гологорский В.А.,Бурневич С.З. и др. Антибактери-альная терапия абдоминальнойхирургической инфекции. М.;2002. с. 144.
  • 46. Яковлев С.В. Современныйвзгляд на антибактериальную те-рапию интраабдоминальных ин-фекций. Consilium Medicum2001;4:304-9.
  • 47. Mosdell D.M., Morris D.M., Vol-tura A., et al. Antibiotic treatmentfor surgical peritonitis. Ann Surg1991;214:543-9.
  • 48. Dellinger E.P., Wertz M.J., Mea-kins J.L., et al. Surgical infectionstratification system for intra-abdominal infection. Arch Surg1985;120:21-9.
  • 49. Christou N.V., Barie P.S., Dellin-ger E.P., et al. Surgical InfectionSociety intra-abdominal infectionstudy. Prospective evaluation ofmanagement techniques and out-come. Arch Surg 1993;128:193-9.
  • 50. Bohnen J.M., Mustard R.A., Schou-ten B.D. Steroids, APACHE IIscore, and the outcome of abdo-minal infection. Arch Surg1994;129:33-7.
  • 51. Schoeffel U., Jacobs E., Ruf G., et al.Intraperitoneal microorganismsand the severity of peritonitis. Eur JSurg 1995;161:501-8.
  • 52. Pacelli F., Doglietto G.B., Alfieri S.,et al. Prognosis in intra-abdominalinfections. Multivariate analysis on604 patients. Arch Surg 1996;131:641-5.
  • 53. Ohmann C., Hau T. Prognosticindices in peritonitis. Hepato-gastroenterology 1997;44:937-46.
  • 54. Wacha H., Hau T., Dittmer R., etal. Risk factors associated withintra-abdominal infections: aprospective multicenter study.Langenbecks Arch Surg 1999;384:24-32.
  • 55. Hopkins J.A., Lee J.C.H., Wil-son S.E. Susceptibility of intra-abdominal isolates at operation: apredictor of postoperative infec-tion. Am Surg 1993;59:791-6.
  • 56. Montravers P., Gauzit R., Mul-ler C., et al. Emergence of antibioticresistant bacteria in cases of peri-tonitis after intra-abdominalsurgery affects the efficacy ofempirical antimicrobial therapy.Clin Infect Dis 1996;23:486-94.
  • 57. Cometta A., Baumgartner J.D.,Lew D., et al. Prospective rando-mized comparison of imipenemmonotherapy with imipenem plusnetilmicin for treatment of severeinfections in nonneutropenicpatients. Antimicrob AgentsChemother 1994;38:1309-13.
  • 58. Hoogkamp-Korstanje J.A. Cipro-floxacin vs. cefotaxime regimens forthe treatment of intra-abdominalinfections. Infection 1995;23:278-82.
  • 59. Dupont H., Carbon C., Carlet J.,The Severe Generalized PeritonitisStudy Group. Monotherapy with abroad-spectrum beta-lactam is aseffective as its combination with anaminoglycoside in treatment ofsevere generalized peritonitis: amulticenter randomized controlledtrial. Antimicrob Agents Chemo-ther 2000;44:2028-33.
  • 60. Burnett R.J., Haverstock D.C.,Dellinger E.P., et al. Definition of the role of enterococcus in intraab-dominal infection: analysis of aprospective randomized trial.Surgery 1995;118:716-23.
  • 61. Solomkin J.S., Flohr A.B., Qu-ie P.G., et al. The role of Candidainintraperitoneal infections. Surgery1980;88:524-30.
  • 62. Calandra T., Bille J., Schneider R.,et al. Clinical significance of Candidaisolated from peritoneum in sur-gical patients. Lancet 1989;2(8677):1437-40.
  • 63. Eggiman P., Francioli P., Bille J., etal. Fluconazole prophylaxis pre-vents intra-abdominal candidiasisin high-risk surgical patients. CritCare Med 1999;27:1066-72.
  • 64. Abele-Horne M., Kopp A., Stern-berg U., et al. A randomized studycomparing fluconazole with ampho-tericin B/5-flucytosine for thetreatment of systemicCandidainfections in intensive care pati-ents. Infection 1996;24:426-32.
  • 65. Rotstein O.D., Pruett T.L.,Simmons R.L. Microbiologic fea-tures and treatment of persistentperitonitis in patients in the inten-sive care unit. Can J Surg1986;29:247-50.
  • 66. Nathens A.B., Rotstein O.D.,Marshall J.C. Tertiary peritonitis:clinical features of a complex noso-comial infection. World J Surg1998;22:158-63.
  • 67. Solomkin J.S. Antibiotic resistancein postoperative infections. CritCare Med 2001;29(Suppl):N97-N99.
  • 68. Страчунский Л.С., Решедько Г.К., Рябкова Е.Л. и др. Реко-мендации по оптимизации анти-микробной терапии нозокоми-альных инфекций, вызванныхграмотрицательными бактерия-ми в отделениях реанимации иинтенсивной терапии. Клин мик-робиол антимикроб химиотер2002;4:379-90.
  • 69. Страчунский Л.С., Решедь-ко Г.К., Стецюк О.У., АндрееваА.С., Щебников А.Г., исследова-тельская группа РОСНЕТ. Срав-нительная активность антисине-гнойных антибиотиков в отноше-нии нозокомиальных штаммовPseudomonas aeruginosa, выделен-ных в отделениях реанимации иинтенсивной терапии России.Клин микробиол антимикроб хи-миотер 2003;5:35-46.
  • 70. Гарау Х. Основы рациональноговыбора антимикробных препара-тов при интраабдоминальных ин-фекциях (Лекция). Клин микро-биол антимикроб химиотер2002;4:278-87.
Views
0 Abstract
0 PDF
0 Crossref citations
Shared