What every intensivist should know about the management of peritonitis in the intensive care unit

Waele, Jan J. De

doi:10.5935/0103-507x.20180007

Cited by 3 publications

(2 citation statements)

References 45 publications

(51 reference statements)

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“…Our findings reveal a much smaller proportion of anaerobes than previously reported (0.9% vs. 7.7%–22.9%),121638 although one study reported a similar proportion 23. Several guidelines on the management of complicated IAIs have indicated the role of intraabdominal culture and susceptibility testing.…”

Section: Discussioncontrasting

confidence: 71%

“…Hospitalized patients are often at a risk for IAIs caused by carbapenem-resistant Enterobacteriaceae and carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter species along with vancomycin-resistant enterococci (VRE) 215. These problems of antimicrobial resistance complicate the decision-making process when choosing appropriate antibiotic therapy 816…”

Section: Introductionmentioning

confidence: 99%

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Antimicrobial Susceptibility of Microorganisms Isolated from Patients with Intraabdominal Infection in Korea: a Multicenter Study

et al. 2019

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Background: This study evaluated the antimicrobial susceptibility of pathogens isolated from Korean patients with intraabdominal infections (IAIs). Methods: This multicenter study was conducted at 6 university-affiliated hospitals in Korea between 2016 and 2018. All patients with microbiologically proven IAIs were retrospectively included, while patients with spontaneous bacterial peritonitis or continuous ambulatory peritoneal dialysis peritonitis were excluded. Identification and antimicrobial susceptibility testing were performed using automated microbiology systems. Results: A total of 2,114 non-duplicated clinical isolates were collected from 1,571 patients. Among these pathogens, 510 (24.1%) were isolated from nosocomial infections, and 848 isolates (40.1%) were associated with complicated IAIs. The distribution of the microorganisms included aerobic gram-negative (62.6% of isolates), aerobic gram-positive (33.7%), anaerobic (0.9%), and fungal (2.8%) pathogens. The most common pathogens were Escherichia coli (23.8%), followed by Enterococcus spp. (23.1%) and Klebsiella spp. (19.8%). The susceptibility rates of E. coli and Klebsiella spp. to major antibiotics were as follows: amoxicillin/clavulanate (62.5%, 83.0%), cefotaxime (61.4%, 80.7%), ceftazidime (63.7%, 83.1%), cefepime (65.3%, 84.3%), ciprofloxacin (56.4%, 86.3%), piperacillin/tazobactam (99.0%, 84.8%), amikacin (97.4%, 98.3%), and imipenem (99.8%, 98.8%). The susceptibility rates of Enterococcus spp. to ampicillin were 61.0%, amoxicillin/clavulanate, 63.6%; ciprofloxacin, 49.7%; imipenem, 65.2%; and vancomycin, 78.2%. The susceptibility rates of Pseudomonas aeruginosa and Acinetobacter spp. to imipenem were 77.4% and 36.7%, respectively. Conclusion: Enterococcus spp. with susceptibility to limited antibiotics was one of the main pathogens in Korean IAIs, along with E. coli and Klebsiella spp., which were highly susceptible to imipenem, amikacin, and piperacillin/tazobactam. Meanwhile, the low susceptibilities of E. coli or J Korean Med Sci. 2019 Dec 9;34(47):e309 https://doi.

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Section: Discussioncontrasting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Antimicrobial Susceptibility of Microorganisms Isolated from Patients with Intraabdominal Infection in Korea: a Multicenter Study

et al. 2019

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Optimal duration of antibiotic treatment in Gram-negative infections

Waele

Martín‐Loeches

2018

Current Opinion in Infectious Diseases

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Purpose of review Whilst many guidelines recommend limiting the use of antibiotics because of the increase in antimicrobial resistance (AMR), this strategy becomes challenging when dealing with severe infections in critically ill patients. Moreover, some Gram-negative bacilli (GNB) can exhibit mechanisms of resistance that make the patient more vulnerable to recurrence of infections. We reviewed recent data on the optimal duration of antibiotic therapy in these patients. Recent findings Apart from having no additional clinical benefit at a certain point after initiation, antibiotics might have negative effects. Prolonged antibiotic exposure has been associated to development of AMR and represents a strong reason to avoid long courses of antibiotic therapy in GNB infections. Recent data suggest that also patients with severe infections, in whom source control is adequate, can be managed with short-course antibiotic therapy. Summary The optimal duration of antibiotic therapy depends on many factors, but overall, many infections in the critically ill can be treated with short-course antibiotic therapy (7 days or less). The integration of signs of resolution, biomarkers, clinical judgment, and microbiologic eradication might help to define this optimal duration in patients with life-threatening infections caused by GNB.

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A Case of Bilateral Subphrenic Abscess Mimicking Bilateral Postoperative Pleural Effusion

Saha¹,

Chakraborty²,

Sain³

et al. 2023

Bengal Physician Journal

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What every intensivist should know about the management of peritonitis in the intensive care unit

Cited by 3 publications

References 45 publications

Antimicrobial Susceptibility of Microorganisms Isolated from Patients with Intraabdominal Infection in Korea: a Multicenter Study

Antimicrobial Susceptibility of Microorganisms Isolated from Patients with Intraabdominal Infection in Korea: a Multicenter Study

Optimal duration of antibiotic treatment in Gram-negative infections

A Case of Bilateral Subphrenic Abscess Mimicking Bilateral Postoperative Pleural Effusion

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