Management of secondary peritonitis: our experience

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Andrea Cavallaro
Vito Catania
Marco Cavallaro
Antonio Zanghì
Alessandro Cappellani

Abstract

Intra-abdominal infections are a common cause of nosocomial sepsis and are associated with a severe morbility, mortality and sanitary economy implications, especially for decentrated sanitary structures. Mortality due to diffuse suppurative peritonitis (from 10 to 20%) nowadays continues to be unacceptably high. Patients outcome is significatively influenced by early adequate surgery and/or peritoneal drainage: moreover, even early and adequate empiric antimicrobial therapy influences patients morbidity and mortality. Multiple empirical regimens have been proposed, but rarely supported by reliable randomized-controlled studies. The authors report 201 cases of patients with fever and meaningful peritoneal involvement occurred since August 1999 up to August 2005: 110 cases were conservatively treated, 91 cases were surgically treated. The paper summarizes IDAB (Infection Disease Advisory Board) guidelines inheriting management of intra-abdominal infections: empiric antimicrobial therapy for the most common causes of abdominal infections is proposed for low-mid level risk patients, focusing on antibiotic treatment duration. High risk patients need to be evaluated paying particular attention to timely surgical infection source control.


CONCLUSION: Despite of the progress in antimicrobial agents and intensive care treatment, peritonitis is still one of the most important infectious problems that a surgeon has to face.

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How to Cite
Cavallaro, Andrea, et al. “Management of Secondary Peritonitis: Our Experience”. Annali Italiani Di Chirurgia, vol. 79, no. 4, July 2008, pp. 255-60, https://annaliitalianidichirurgia.it/index.php/aic/article/view/1213.
Section
Review