PowerPoint Slideshow about 'Choice of Antibiotics in Diverticulitis' - Mercy
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425 patients who required surgery for community-acquired secondary peritonitis, including patients with complicated diverticulitis.
13% of patients did not receive appropriate antibiotics, defined as not covering all bacteria later isolated or not empirically covering typical aerobic and anaerobic organisms in the absence of culture results.
26% of appropriately treated patients and 30% of inappropriately treated patients had colonic sources of infection.
Resolution of infection with initial or step-down therapy after primary surgery was significantly less likely to occur (53% vs. 79%).
Failure of resolution of infection due to inadequate choice of antibiotics resulted in six-day prolongation of stay in hospital (20 versus 14 days total).
Antibiotic coverage must cover both Gram-negative rods and anaerobes, or infections will persist longer and prolong length of stay in hospital.
Single or multiple antibiotic regimens are equally effective as long as coverage is adequate- this equivalency amongst choices is probably why there aren’t any recent studies attempting to identify superior drugs!
Top choices by ASCRS Fellows include: ciprofloxacin plus metronidazole, ciprofloxacin alone and amoxicillin/clavulanate.
The dominant consideration regarding choice of antibiotics is coverage of GNRs and anaerobes!