ArticleCritical care (London, England)2010
Risk factors for multidrug resistant bacteria and optimization of empirical antibiotic therapy in postoperative peritonitis.
Article in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 107 citations in OpenAlex.
- Pooled it
- Antibiotics for Intra-Abdominal Infections: When, Which, How and How Long?Antibiotics (Basel, Switzerland) · 2025Review
- Article
- Epidemiological analysis of intra-abdominal infections in Italy from the Italian register of complicated intra-abdominal infections-the IRIS study: a prospective observational nationwide study.World journal of emergency surgery : WJES · 2025Observational
- Establishment of epidemiological cut-off values for eravacycline, against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter baumannii and Staphylococcus aureus.The Journal of antimicrobial chemotherapy · 2024Article
- Source Control and Antibiotics in Intra-Abdominal Infections.Antibiotics (Basel, Switzerland) · 2024Review
- Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use.World journal of emergency surgery : WJES · 2024Review
- Microbiological profile of patients treated for postoperative peritonitis: temporal trends 1999-2019.World journal of emergency surgery : WJES · 2023Article
- Optimized Treatment of Nosocomial Peritonitis.Antibiotics (Basel, Switzerland) · 2023Review
- Establishment of a risk prediction model for multidrug-resistant bacteria in deceased organ donors: a retrospective cohort study in China.Frontiers in cellular and infection microbiology · 2023Article
- Outcomes of Beta-Lactam Allergic and Non-Beta-Lactam Allergic Patients with Intra-Abdominal Infection: A Case-Control Study.Antibiotics (Basel, Switzerland) · 2022Article
- A Proposal for a Classification Guiding the Selection of Appropriate Antibiotic Therapy for Intra-Abdominal Infections.Antibiotics (Basel, Switzerland) · 2022Review
- Surgical site infections caused by multi-drug resistant organisms: a case-control study in general surgery.Updates in surgery · 2022Article
- Healthcare-associated infections in adult intensive care unit patients: Changes in epidemiology, diagnosis, prevention and contributions of new technologies.Intensive & critical care nursing · 2022Article
- Is ß-d-glucan Relevant for the Diagnosis and Follow-Up of Intensive Care Patients with Yeast-Complicated Intra-Abdominal Infection?Journal of fungi (Basel, Switzerland) · 2022Article
- Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study.Infectious diseases and therapy · 2022Article
- Review of Colonic Anastomotic Leakage and Prevention Methods.Journal of clinical medicine · 2020Review
- Article
- Post-operative abdominal infections: epidemiology, operational definitions, and outcomes.Intensive care medicine · 2020Review
- Management of anastomotic leakage after rectal surgery: a review article.Journal of gastrointestinal oncology · 2019Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe main objective was to determine risk factors for presence of multidrug resistant bacteria (MDR) in postoperative peritonitis (PP) and optimal empirical antibiotic therapy (EA) among options proposed by Infectious Disease Society of America and the Surgical Infection Society guidelines.
methodsOne hundred patients hospitalised in the intensive care unit (ICU) for PP were reviewed. Clinical and microbiologic data, EA and its adequacy were analysed. The in vitro activities of 9 antibiotics in relation to the cultured bacteria were assessed to propose the most adequate EA among 17 regimens in the largest number of cases.
resultsA total of 269 bacteria was cultured in 100 patients including 41 episodes with MDR. According to logistic regression analysis, the use of broad-spectrum antibiotic between initial intervention and reoperation was the only significant risk factor for emergence of MDR bacteria (odds ratio (OR) = 5.1; 95% confidence interval (CI) = 1.7 - 15; P = 0.0031). Antibiotics providing the best activity rate were imipenem/cilastatin (68%) and piperacillin/tazobactam (53%). The best adequacy for EA was obtained by combinations of imipenem/cilastatin or piperacillin/tazobactam, amikacin and a glycopeptide, with values reaching 99% and 94%, respectively. Imipenem/cilastin was the only single-drug regimen providing an adequacy superior to 80% in the absence of broad spectrum antibiotic between initial surgery and reoperation.
conclusionsInterval antibiotic therapy is associated with the presence of MDR bacteria. Not all regimens proposed by Infectious Disease Society of America and the Surgical Infection Society guidelines for PP can provide an acceptable rate of adequacy. Monotherapy with imipenem/cilastin is suitable for EA only in absence of this risk factor for MDR. For other patients, only antibiotic combinations may achieve high adequacy rates.
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