amoxicillin-potassium-clavulanate-combination and Abdominal-Injuries

This article describes the non-operative management of five patients with ballistic abdominal solid organ injuries in a role 2E medical treatment facility. The selective non-operative management of ballistic abdominal solid organ injury is an accepted management strategy in high-volume civilian trauma centres, and appears to be equally safe and effective in the deployed military setting.

Topics: Abdominal Injuries; Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bombs; Child; Debridement; Explosive Agents; Humans; Male; Military Medicine; Thoracic Injuries; United Kingdom; Wounds, Gunshot; Young Adult

Escherichia coli remains one of the most common etiologies of secondary peritonitis. CMY-2 is the most prevalent AmpC enzyme identified in nosocomial E. coli isolates causing bacteremia in Taiwan. This report is of a patient who underwent surgery for intestinal perforations due to blunt abdominal trauma and developed unexpected CMY-2-producing E. coli septicemia in the early postoperative period. The AmpC-type CMY-2 enzyme might partially contribute to the poor response to antimicrobial therapy of amoxicillin-clavulanic acid or flomoxef. Late changes in antibiotic therapy to an appropriate regimen of cefpirome based on the culture results did not result in a positive outcome and the patient died. Whether selection of an anti-AmpC regimen is appropriate as first-line treatment for traumatic abdomen-associated septicemia should be an area of further investigation in Taiwan.

Topics: Abdominal Injuries; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; beta-Lactamases; Cephalosporins; Escherichia coli; Escherichia coli Infections; Female; Humans; Sepsis; Taiwan