colistin and Abdominal-Injuries

Topics: Abdominal Injuries; Coinfection; Colistin; Drug Resistance, Microbial; Enterobacteriaceae; Enterobacteriaceae Infections; Humans; Intestinal Perforation; Intestine, Small; Male; Middle Aged; Peritonitis; Phylogeny; Pneumoperitoneum; Ribotyping; RNA, Bacterial; RNA, Ribosomal, 16S; Sequence Alignment; Sequence Homology, Nucleic Acid; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Wounds, Nonpenetrating

Subphrenic abscess is still a significant hazard which complicates surgical procedures as well as certain abdominal catastrophes. This is a report of 88 patients with subphrenic abscess at St. Vincent's Hospital and Medical Center of New York from 1954 through 1971. There were 46 males and 42 females, ranging from 2 to 88 years. Operations on the stomach, duodenum and biliary tract were the major causes. The causative organisms in order of frequency were: E coli (41.6%), Staphylococcus (41.6%), Aerobacter aerogenes (23.3%), Proteus (20%), Streptococci (18.3%) and Pseudomonas (8.3%). Penicillin and tetracycline, the antibiotics most commonly chosen on an empiric basis, proved effective in only 38% of cases. On the other hand, kanamycin, chloramphenicol and cephalothin were effective in 90%, 85% and 70% of cases respectively. The overall mortality rate was 15%. Nine of the 21 patients (42.8%) treated with antibiotics alone died while 11 of 67 patients (10.6%) treated with antibiotics and surgical drainage died. Some of the latter deaths occurred in patients treated with prolonged antibiotic therapy and operated on only as a last resort. In this series subphrenic abscess was best treated by early surgical drainage combined with the use of appropriate antibiotics.

Topics: Abdominal Injuries; Adolescent; Adult; Aged; Anti-Bacterial Agents; Child; Child, Preschool; Chloramphenicol; Colistin; Drug Resistance, Microbial; Escherichia coli Infections; Female; Humans; Infant; Kanamycin; Male; Microbial Sensitivity Tests; Middle Aged; Postoperative Complications; Radiography; Staphylococcal Infections; Subphrenic Abscess; Surgical Procedures, Operative

Topics: Abdominal Injuries; Blood Urea Nitrogen; Cardiac Output; Colistin; Creatinine; Humans; Kanamycin; Kidney; Male; Military Medicine; Osmolar Concentration; Penicillins; Sepsis