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Antibiotics for the acute abdomen

M S Farber1, J H Abrams

  • 1Department of Surgery, University of Minnesota Medical School, Minneapolis, USA.

The Surgical Clinics of North America
|January 31, 1998
PubMed
Summary

Antibiotics are an adjunct to surgical treatment for bacterial secondary peritonitis. Optimal outcomes require timely surgery, appropriate antibiotic selection, and individualized treatment duration to combat resistant pathogens.

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Area of Science:

  • Infectious Diseases
  • Surgical Therapy
  • Pharmacology

Background:

  • Bacterial secondary peritonitis necessitates a multimodal treatment approach.
  • Antibiotics play a crucial role as an adjunct to surgical intervention.
  • Understanding pathogen profiles is key to effective treatment.

Purpose of the Study:

  • To outline the appropriate use of antibiotics in managing bacterial secondary peritonitis.
  • To emphasize the importance of surgical intervention as the primary treatment.
  • To guide antibiotic selection and duration based on patient factors and pathogen identification.

Main Methods:

  • Review of current literature and clinical guidelines on antibiotic use in peritonitis.
  • Analysis of factors influencing pathogen selection and antibiotic resistance.
  • Emphasis on preoperative prophylaxis and postoperative therapeutic antibiotic courses.

Main Results:

  • Preoperative antibiotics are essential for prophylaxis.
  • Postoperative therapeutic antibiotics are indicated for established infections.
  • Antibiotic regimens must cover gram-negative bacilli and anaerobes.
  • Individualized duration and intraoperative cultures are recommended for complex cases.

Conclusions:

  • Early, aggressive surgical management is paramount for resolving bacterial peritonitis.
  • Short courses of potent antibiotics, guided by culture data and patient factors, are preferred.
  • Prolonged, empiric broad-spectrum antibiotic use can be detrimental, promoting resistance and superinfections.

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