Gutiérrez BSG, García MC, González CJR, Saldaña FGE

Language: Spanish
References: 15
Page: 34-39
PDF size: 141.57 Kb.

ABSTRACT

Introduction: It is imperative to establish the effectiveness of the empiric antimicrobial therapy in inpatients with abdominal sepsis at Christus Muguerza Hospital, the attachment to international guidelines of empiric antibiotic management, the frequency of microbial species in cultures and its sensitivity to the suggested antibiotics by these guidelines; also, to establish the days of stay and in the ICU.
Materials and methods: The relative risk was calculated to patients who came in to the Hospital with a diagnosis of Intra-abdominal infection which will need surgical management (IIMQ), who of these received management according to guidelines and who didn’t, their follow up and outcomes, if there was change of antibiotic therapy, stay in ICU and as inpatients, and mortality.
Results and conclusions: Every patient received antibiotic therapy, for 20 patients (74.1%), there wasn’t attachment to guidelines, and for the other 7 (25.9%) there was. The days of stay were 11 (SD 6.9) in the attachment group and 10 days (SD 8.1) for the other group. Patients who needed ICU: 10 days (SD3), for the attachment group vs 6 days (SD 3) for the other group. There weren’t fatal cases. In 4 patients in which there was attachment to guidelines, bacteria found were sensitive to the antibiotic used, in 1 patient weren’t. In the No attachment group, 50 % were sensitive and 50% resistant, for a RR of 1.6 (CI 95% 0.54-4.6). Cultures results match with isolated bacteria reported in world literature, so it is deducted that added to this study’s results, antimicrobial management guidelines for patients with IIMQ would be effective in Christus Muguerza Hospital, and its regular use could be recommended.

REFERENCES

1. Solomkin JS et al. Diagnóstico y tratamiento de infecciones intraabdominales complicadas en adultos y niños: guías de la Surgical Infection Society y la Infectious Diseases Society of America. Clin Infect Dis 2010;50:133-164.

2. Husted TL et al. (editors). Clinician’s Manual on Intra-abdominal Infections.London: Springer Healthcare 2010;53-70.

3. Sanz GO. Tratamiento antibiótico empírico de la infección intraabdominal. Clínicas de Cirugía General, Maitines 2011;1-9.

4. Gartz V. Hoja de cálculo para tamaño de Muestra, 2003.

5. [s.a.], “Riesgo relativo” en Material docente de la Universidad de Bioestadística Clínica. Hospital UniversitarioRamón y Cajal. Madri, [s.a.]. Disponible en: http://www.hrc.es/bioest/Medidas_frecuencia_62.html

6. Dellit TH, Owens RC, McGowan JE et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of American Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship. Clin Infect Dis 2007;44(2):159-77. Disponible en: cid.oxfordjournals.org/content/4412/159.full.

7. Hohmann C et al. Adherence to guidelines for antibiotic prophylaxis in surgery patients in German Hospitals: a multicentre evaluation involving pharmacy interns. Infection 2012;40(2):131-137.

8. Eckmann C et al. Antimicrobial treatment of “complicated” intra-abdominal infections and the new IDSA guidelines? a commentary and an alternative European approach according to clinical definitions. Eur J Med Res 2011;16(3):115-126.

9. Maseda E, Gilsanz F. Duration of antibiotic therapy in intraabdominal infections. Enfermedades Infecciosas y Microbiología Clínica 2010;28(suppl 2):49-52.

10. Kambaroudis AG et al. Perioperative use of antibiotics in intra-abdominal surgical infections. Surg Infect (Larchmt) 2010;11(6):535-544.

11. Baquero F. In vitro susceptibilities of aerobic and facultative anaerobic gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2005 results from study for monitoring antimicrobial resistance trends (SMART). Surg Infect (Larchmt) 2009;(2):99-104.

12. Concia E, Viscoli C. Principles and application protocols in the treatment of intra-abdominal infections. Infez Med 2008;16(Suppl 1):57-62.

13. Laterre PF et al. Antimicrobial therapy for intra-abdominal infections: guidelines from the infectious disease advisory board (IDAB). Acta Chir Bel 2006;106:2-21.

14. Blot S, De Waele JJ. Critical issues in the clinical management of complicated intra-abdominal infections. Drugs 2005;65:1611-1620.

15. [s.a.], Metodología de la investigación, [s.l.],[s.a.], [s.p.]. Disponible en: http://www.fisterra.com/mbe/investiga/index.asp