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Therapeutic efficacy of 29 antimicrobial regimens in experimental intraabdominal sepsis
Abstract:
An animal model of colonic perforation was used to examine the efficacy of 29 antimicrobial regimens in the treatment of intraabdominal sepsis. Efficacy was judged on mortality during the first 12 days after challenge and on the incidence of intraabdominal abscess noted at necropsy upon completion of the experiment. In general, antimicrobial agents that are active against coliform bacteria prevented early mortality, whereas drugs that are active against Bacteroides fragilis were most effective in reducing the incidence of late abscess formation. Exceptions were metronidazole, which produced a significant reduction in early mortality, and chloramphenicol, which caused only a modest reduction in the incidence of abscess. Optimal results were obtained with several regimens that showed good in vitro activity against both coliforms and B. fragilis.
Insights
This study on intraabdominal sepsis found that antimicrobial drugs targeting coliform bacteria reduced early mortality, while those effective against Bacteroides fragilis decreased late abscess formation. Optimal treatment regimens covered both bacterial types.
Area of Science:
- Microbiology
- Infectious Diseases
- Surgical Infections
Background:
- Intraabdominal sepsis is a serious condition often involving polymicrobial infections.
- Effective treatment requires addressing both early mortality and late complications like abscess formation.
Purpose of the Study:
- To evaluate the efficacy of 29 antimicrobial regimens in an animal model of colonic perforation.
- To determine which antimicrobial spectra are most effective against early mortality and late abscesses in intraabdominal sepsis.
Main Methods:
- An established animal model of colonic perforation was utilized.
- Mortality within 12 days and intraabdominal abscess incidence at necropsy were the primary efficacy measures.
- The in vitro activity of antimicrobial agents against key pathogens was considered.
Main Results:
- Antimicrobials active against coliform bacteria were effective in preventing early mortality.
- Agents targeting Bacteroides fragilis were superior in reducing the incidence of late intraabdominal abscesses.
- Metronidazole showed efficacy against early mortality, while chloramphenicol had a modest effect on abscesses.
Conclusions:
- Treatment strategies for intraabdominal sepsis should consider the specific bacterial pathogens involved.
- Regimens with broad-spectrum activity against both coliforms and Bacteroides fragilis demonstrated optimal efficacy.
- Targeting both early mortality and late sequelae is crucial for effective management of intraabdominal sepsis.