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[Meropenem in the treatment of surgical intra-abdominal infections]
1Catedrático de Cirugía, Facultad de Medicina de la Universidad de Santiago, Santiago de Compostela.
Abstract:
Intraabdominal infections are severe with a high morbidity and mortality which may be produced by multiple causes: perforation of the empty viscera, intestinal inflammatory processes, vascular pictures, abdominal traumatisms as a consequence of surgery. From a microbiologic point of view, different types of gram positive and gram negative aerobes such as anaerobe microorganisms or fungi may be isolated as causes. Polymicrobial infections are usually observed. The main treatment policy is to correctly eliminate the causing foci of the bacterial contamination whether surgically of by percutaneous drainage. Parallelly, it is essential for the surgeon to use appropriate antibiotic treatment. Meropenem, a carbapenem, has a wide spectrum antibacterial activity which cover gram positive and gram negative aerobes in addition to anaerobes leading to scarce adverse reactions. All the above leads meropenem to be a very effective alternative in both the treatment of these infections as monotherapy and for initiating empiric therapy.
Insights
Intraabdominal infections are serious, often caused by multiple microbes. Meropenem, a broad-spectrum carbapenem antibiotic, is effective for treating these infections due to its wide coverage and safety profile.
Area of Science:
- Infectious Diseases
- Surgical Infections
- Microbiology
Background:
- Intraabdominal infections present significant morbidity and mortality.
- Causes include visceral perforation, inflammation, vascular issues, and surgical trauma.
- Microbiologically, these infections are often polymicrobial, involving Gram-positive, Gram-negative aerobes, anaerobes, and fungi.
Purpose of the Study:
- To evaluate meropenem as a treatment option for intraabdominal infections.
- To highlight the role of broad-spectrum antibiotics in managing complex infections.
Main Methods:
- Review of treatment strategies for intraabdominal infections.
- Assessment of meropenem's antibacterial spectrum and adverse reaction profile.
- Analysis of meropenem's efficacy in monotherapy and empiric treatment.
Main Results:
- Meropenem exhibits broad-spectrum activity against Gram-positive, Gram-negative aerobes, and anaerobes.
- The carbapenem demonstrates a low incidence of adverse reactions.
- Meropenem is effective as monotherapy and for initiating empiric treatment.
Conclusions:
- Effective source control (surgical or percutaneous drainage) is crucial.
- Appropriate antibiotic therapy, such as meropenem, is essential.
- Meropenem is a highly effective therapeutic choice for intraabdominal infections, suitable for monotherapy and empiric use.