Management of surgical infections

Results of treatment of 151 surgical infections with a variety of antimicrobial regimes were retrospectively compared. Diagnoses included diffuse peritonitis (43), severe soft tissue infections (11), septicaemia accompanying abdominal infections (29), intra-abdominal abscesses (36), local peritonitis (27) and other localized infections (5). A total of 211 anaerobic and 130 aerobic strains were isolated. A cure rate of 92% was achieved with metronidazole or ornidazole used alone and 89% with these nitroimidazoles plus an aminoglycoside. Results were equally satisfactory regardless of whether a surgical procedure, such as drainage was performed. Clindamycin and the aminoglycosides had satisfactory results in combination, but not when used alone. Good controlled trials are now justified to define the need for an aminoglycoside and/or surgery in addition to a nitroimidazole.