ArticleAnnals of clinical microbiology and antimicrobials2015
Spectrum adequacy of antibiotic regimens for secondary peritonitis: a retrospective analysis in intermediate and intensive care unit patients.
Article in Annals of clinical microbiology and antimicrobials, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 27 citations in OpenAlex.
- Antibiotic sensitivity in correlation to the origin of secondary peritonitis: a single center analysis.Scientific reports · 2020Trial
- Antibiotics for Intra-Abdominal Infections: When, Which, How and How Long?Antibiotics (Basel, Switzerland) · 2025Review
- Guidelines for Antibiotics Prescription in Critically Ill Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use.World journal of emergency surgery : WJES · 2024Review
- Optimized Treatment of Nosocomial Peritonitis.Antibiotics (Basel, Switzerland) · 2023Review
- A Literature Overview of Secondary Peritonitis Due to Carbapenem-Resistant Enterobacterales (CRE) in Intensive Care Unit (ICU) Patients.Antibiotics (Basel, Switzerland) · 2022Review
- Microbial Spectrum and Antibiotic Resistance in Patients Suffering from Penetrating Crohn's Disease.Journal of clinical medicine · 2022Article
- Tertiary peritonitis: A disease that should not be ignored.World journal of clinical cases · 2021Review
- The Bucharest ESTES consensus statement on peritonitis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020Review
- Guidelines for Antibiotic Prescription in Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2019Article
- What every intensivist should know about the management of peritonitis in the intensive care unit.Revista Brasileira de terapia intensiva · 2018Article
- [Multidrug resistant gram-negative bacteria : Clinical management pathway for patients undergoing elective interventions in visceral surgery].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2018Review
- Management of intra-abdominal infections: recommendations by the WSES 2016 consensus conference.World journal of emergency surgery : WJES · 2017Review
- Bacterial and Antibiotic Sensitivity Pattern in Secondary Peritonitis.Journal of the West African College of SurgeonsArticle
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSecondary peritonitis requires surgical source control and adequate antimicrobial treatment. Antimicrobial regimens are usually selected according to local susceptibility data of individual pathogens against single agents, but this neglects both the polymicrobial nature of the infection and the use of combination therapy. We analysed the probability of common regimens to cover all relevant pathogens isolated in one patient ("spectrum adequacy rate", SAR) in a real-life data set.
methodsData from 242 patients with secondary peritonitis (88 community acquired, 154 postoperative cases) treated in our IMCU/ICU were obtained retrospectively. The relative frequency of pathogens, resistance rates and the SAR were analysed using the free software R.
resultsEnterococci were isolated in 47.1 % of all patients, followed by Escherichia coli (42.6 %), other enterobacteriaceae (33.1 %), anaerobes (29.8 %) and Candida spp. (28.9 %). Resistance patterns were consistent with general surveillance data from our hospital. The susceptibility rates and SAR were lower in postoperative than in community acquired cases. The following regimens yielded a SAR > 95 % when enterobacteriaceae only were considered: piperacillin/tazobactam + gentamicin, cefotaxim (only for community acquired cases), cefotaxim + gentamicin, meropenem, tigecycline + gentamicin or tigecycline + ciprofloxaxin. When enterococci were also considered, all betalactam based regimens required combination with vancomycin or linezolid for a SAR > 95 %, whereas TGC based regimens were not compromised. As for Candida spp., the SAR of fluconazole was 81.9-87.5 %.
conclusionsThis study demonstrates a rational approach to assess the adequacy of antimicrobial regimens in secondary peritonitis, which may help to adjust local guidelines or to select candidate regimens for clinical studies.
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