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Updated: Aug 1, 2026

Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis
Published on: December 18, 2010
[Bacterial translocation from the gastrointestinal tract: catalyst of multiple organ dysfunction syndrome]
Abstract:
The abnormal colonization of gastrointestinal tract (GIT), the loss of the intestinal barrier function, the bacterial translocation (BT) are signs of intestinal insufficiency which are supposed to be involved in the pathogenesis of MODS. This worsens the condition or leads to lethal outcome in patients after major abdominal surgery in ICU. The goal of this investigation was to consider the scientific and clinical evidence for the BT role in the pathogenesis of MODS and to present evidence about the advantages and the efficiency of antibiotic combination Amikacin plus Clindamycin as a new therapeutic strategy for the improvement of the outcome in patients with MODS and sepsis. To that purpose patients with diffuse peritonitis of different origin were analyzed. After surgery some patients were left with laparostomy. This gave the possibility for revisions and lavages of the abdominal cavity and for taking material for microbiological analyses. The patients were grouped into two subgroups according to antibiotic treatment: 1st group--combination of usually used antibiotics; 2nd group--Amikacin plus Clindamycin. The second group patients showed good tolerance to this antibiotic combination and good therapeutic effect.
Insights
Bacterial translocation (BT) contributes to multiple organ dysfunction syndrome (MODS) after surgery. Amikacin plus Clindamycin showed a good therapeutic effect for patients with MODS and sepsis.
Area of Science:
- Gastroenterology
- Critical Care Medicine
- Infectious Diseases
Background:
- Intestinal insufficiency, marked by abnormal gut microbiota, barrier dysfunction, and bacterial translocation (BT), is implicated in the pathogenesis of multiple organ dysfunction syndrome (MODS).
- MODS significantly worsens patient outcomes, particularly in intensive care unit (ICU) patients following major abdominal surgery.
Purpose of the Study:
- To review scientific and clinical evidence on the role of BT in MODS pathogenesis.
- To evaluate the efficacy of Amikacin plus Clindamycin as a novel therapeutic strategy for improving outcomes in MODS and sepsis patients.
Main Methods:
- Analysis of patients with diffuse peritonitis of various origins.
- Patients were grouped based on antibiotic treatment: standard antibiotics versus Amikacin plus Clindamycin.
- Microbiological analyses were performed on abdominal cavity samples from patients with laparostomy.
Main Results:
- The Amikacin plus Clindamycin combination was well-tolerated by patients.
- This antibiotic regimen demonstrated a good therapeutic effect in the subgroup of patients studied.
Conclusions:
- Bacterial translocation plays a crucial role in the development of MODS.
- Amikacin plus Clindamycin presents a promising therapeutic option for managing MODS and sepsis, improving patient outcomes.
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