Antibiotics for Abdominal Infection
Antibiotic therapy for abdominal infection
Whether expanded antimicrobial coverage is required, especially in hospital-acquired infections, is controversial. Candida infections should be treated with antifungal therapy in patients with recurrent abdominal infections, immunosuppressed patients, and those with candidal abscesses. Most agents have few serious adverse effects; aminoglycosides are the least expensive agents but cause nephro- and ototoxicity.
There is little information on the promotion of drug resistance in this condition. Recent developments include the introduction of ticarcillin/clavulanic acid, ampicillin/ sulbactam, piperacillin/tazobactam, meropenem, aztreonam/clindamycin, and ciprofloxacin/metronidazole; success with once-daily aminoglycosides; evidence that antibiotics limit infectious complications of pancreatitis; controversy over the value of diagnostic cultures; the use of oral therapy; evidence in favor of shorter courses of treatment; and the introduction of pharmacoeconomic studies. Clinical investigators are challenged to improve drug trials by stratifying and controlling for the adequacy of surgical intervention.
High-risk intra-abdominal infection patients
Antibiotics for high-risk intra-abdominal infection
Duration of antibiotics treatment
1. traumatic or iatrogenic small intestine, colon perforation < 12 hrs
2. gastroduodenal perforation < 24 hrs
3. acute or gangrenous appendicitis without perforation
4. acute or gangrenous cholecystitis without perforation
5. transmural bowel necrosis from embolic, thrombotic or obstructive vascular occlusion without perforation, abscess, peritonitis
agents: unasyn, cefoxitin, taxocin, timentin
for other patients: 5 ~ 7 days antibiotics treatment