PDF(Pubmed)
Abstract：
Background: Appropriate antimicrobial therapy for the management of intra-abdominal infection (IAI) continues to evolve based on available literature. The Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial provided evidence to support four days of antibiotic agents in IAI post-source control but excluded patients with a planned re-laparotomy. This study aimed to determine the short- and long-term recurrent infection risk in this population. Patients and Methods: This is a single-center, retrospective, observational study of adult patients admitted to a quaternary medical center between January 1, 2016, and August 1, 2022, with IAI requiring planned laparotomy. Patients were designated as receiving five or less days of antibiotic agents (short course) or more than five days (long course) after source control. The primary outcome was IAI recurrence within 30 days. Results: Of the 104 patients who met inclusion criteria, 78 were included in analysis. Average age was 57 ± 13.3 years, 56% were male, 94% Caucasian, with a mean Acute Physiology and Chronic Health Evaluation (APACHE) II score of 17 ± 7.09. All other baseline characteristics and clinical severity markers were similar between the two groups. Regarding the primary outcome of IAI recurrence, there was no difference when comparing those who received short course versus those who received long course therapy (41.2% vs. 44.4%; p = 0.781). No differences were found between groups with respect to secondary outcomes. Conclusions: In patients admitted with IAI managed with planned re-laparotomy those who received short course antimicrobial therapy were not found to have an increase in IAI recurrence compared to those with longer courses of therapy.
摘要：
背景：根据现有文献，用于腹腔感染（IAI）管理的适当抗菌疗法仍在不断发展。优化腹膜感染治疗研究（STOP-IT）试验提供了证据，以支持在IAI后来源控制中使用抗生素4天，但排除了计划再次剖腹手术的患者。这项研究旨在确定该人群的短期和长期复发性感染风险。患者和方法：这是一个单中心，回顾性,对2016年1月1日至2022年8月1日期间在一家四级医疗中心收治的IAI需要计划剖腹手术的成年患者进行观察性研究.患者被指定为在源控制后接受5天或更少的抗生素药物（短期疗程）或超过5天（长期疗程）。主要结果是IAI在30天内复发。结果：在符合纳入标准的104例患者中，78人被纳入分析。平均年龄为57±13.3岁，56%为男性，94%白种人,平均急性生理学和慢性健康评估（APACHE）II评分为17±7.09。两组之间的所有其他基线特征和临床严重程度标志物相似。关于IAI复发的主要结果，将接受短期疗程的患者与接受长期疗程的患者进行比较时，没有差异(41.2%与44.4%；p=0.781）。在次要结局方面，组间没有发现差异。结论：在接受IAI治疗并计划再次剖腹手术的患者中，与接受较长疗程的患者相比，接受短期抗菌治疗的患者IAI复发率没有增加。
