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

Praveen Kumar-M1, Nusrat Shafiq2, Pradeep Kumar3

  • 1Department of Pharmacology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Therapeutic Advances in Infectious Disease
|August 9, 2019
PubMed
Abstract

Insights

For secondary peritonitis from intestinal perforation, piperacillin-tazobactam or imipenem are recommended empirical antibiotics. These agents show good sensitivity against common pathogens like E. coli and K. pneumoniae.

Area of Science:

  • Surgical infections
  • Antimicrobial stewardship
  • Clinical microbiology

Background:

  • Secondary peritonitis following intestinal perforation is a common surgical emergency with high mortality.
  • Empirical antibiotic regimens vary significantly, necessitating evidence-based guidance.
  • Antimicrobial stewardship programs aim to optimize antibiotic use in critical care.

Purpose of the Study:

  • To determine the most effective empirical antibiotic regimen for secondary peritonitis due to intestinal perforation.
  • To provide evidence for rational antibiotic selection in a prospective study.
  • To address variations in current clinical practice.

Main Methods:

  • A prospective study of 77 patients with secondary peritonitis over 12 months.
  • Analysis of intraoperative peritoneal fluid for culture and sensitivity patterns.
  • Evaluation of common bacterial isolates and their antibiotic susceptibility.

Main Results:

  • Lower gastrointestinal perforation was most common (50.6%), followed by upper GI (36.4%).
  • Escherichia coli (47.9%) and Klebsiella pneumoniae (12.5%) were the predominant organisms.
  • Piperacillin-tazobactam and imipenem demonstrated high sensitivity against E. coli and K. pneumoniae isolates.

Conclusions:

  • Piperacillin-tazobactam or imipenem are recommended as empirical treatments for complicated intra-abdominal infections from perforated viscus.
  • These antibiotics are particularly advised for patients with sepsis or septic shock.
  • Evidence supports optimizing empirical antibiotic therapy for secondary peritonitis.
Keywords:
antimicrobial stewardshipempirical regimenperforation peritonitisperitonitissurgical prophylaxis

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