Coverage of enterococci in community acquired secondary peritonitis: results of a randomized trial

Surg Infect (Larchmt). 2000 Summer;1(2):95-107. doi: 10.1089/109629600321137.

Abstract

Introduction: The increasing number of enterococcal infections in hospitals and reports about the development of resistance of these bacteria make it necessary to review their importance as co-pathogens in secondary peritonitis.

Materials and methods: A prospective randomized controlled trial on primary therapy of secondary peritonitis was carried out in six centers comparing cephalosporin-based antibiotic therapy to acylaminopenicillin-based therapy.

Results: Enterococci were only cultured in 6 of 110 cases from the abdomen and were found in only 5 cases of postoperative complications. No differences were found between penicillin-based vs. cephalosporin-based therapy.

Conclusion: The study supports the view that these bacteria continue to play a minor role in secondary peritonitis. The point has to be emphasized, however, that the patients under study were in relatively good condition (APACHE II median 9 for cephalosporins and 10 for penicillins) and that postoperative cases of peritonitis were excluded.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase IV
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cephalosporins / therapeutic use*
  • Community-Acquired Infections
  • Digestive System Surgical Procedures / methods
  • Enterococcus / drug effects
  • Enterococcus / pathogenicity*
  • Female
  • Gram-Positive Bacterial Infections / drug therapy*
  • Gram-Positive Bacterial Infections / surgery
  • Humans
  • Male
  • Middle Aged
  • Penicillins / therapeutic use*
  • Peritonitis / drug therapy*
  • Peritonitis / surgery
  • Postoperative Complications / drug therapy
  • Prospective Studies
  • Reoperation
  • Sepsis / drug therapy*
  • Sepsis / surgery
  • Surgical Wound Infection / drug therapy*

Substances

  • Cephalosporins
  • Penicillins