FIRST-LINE MEROPENEM ANTIBIOTIC THERAPY IN ACUTE PERITONITIS SECONDARY TO COLIC PERFORATION. CLINICAL AND HISTOPATHOLOGICAL STUDY ON THE LABORATORY ANIMAL

Authors

  • C.G. FLOREA “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • T. SOARE University of Agronomic Sciences and Veterinary Medicine, Bucharest, Romania
  • I.S. COMAN “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • C. COMAN “Cantacuzino” National Institute of Medical Military Development and Research, Romania
  • M. LITESCU “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
  • Violeta Elena COMAN “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
  • Raluca Maria FLOREA “Sf. Ioan” Emergency Clinical Hospital, Bucharest, Romania
  • A: ERCHILD “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
  • V.T. GRIGORESCU “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania

Abstract

Acute peritonitis accounts for 1% of all on-call visits and is the second leading cause of sepsis worldwide. Annually, due to secondary peritonitis, it is estimated that 20 million years of life are lost, 25 million years are adjusted for disabilities and 896,000 deaths. Fecal peritonitis is one of the most common causes of intensive care admissions with a  mortality rate between 19.1 and 31.6% in some centers exceeding 50%. Material and methods: Taking into account the above, we imagined a study, using laboratory animals, in which we produced sigmoid perforations, then followed their evolution without antibiotic treatment and under antibiotic therapy with Cefuroxime 25 mg/kg/24 hours intravenously or Meropenem 40 mg/kg intravenously, following the tissue changes both macroscopically and microscopically. Results: Our study revealed a mortality rate of 3.33%, the death occurring within 72 hours from the time of perforation. By observing the general condition (clinical point of view), no major differences between batches were found, neither from a macroscopic point of view (inspection of the peritoneal cavity). After microscopic analysis of the peritoneum and sigmoid colon meropenem treatment showed remarkably better results, especially at T4. Conclusions: Meropenem is a first-line antibiotic in acute peritonitis secondary to colonic perforation, which together with surgery can reduce the morbidity and mortality of this pathology.

Author Biographies

  • C.G. FLOREA, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

    Ph.D. Student, Doctoral School
    “Bagdasar-Arseni” Emergency Clinical Hospital, Bucharest, Romania
    Department of General Surgery

  • T. SOARE, University of Agronomic Sciences and Veterinary Medicine, Bucharest, Romania

    Faculty of Veterinary Medicine, Department of Histology

  • I.S. COMAN, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

    Faculty of Medicine Department of Surgery
    “Bagdasar-Arseni” Emergency Clinical Hospital, Bucharest, Romania
    Department of General Surgery

  • C. COMAN, “Cantacuzino” National Institute of Medical Military Development and Research, Romania

    Băneasa Research Department

  • M. LITESCU, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania

    Faculty of Dentistry, Department of Surgery
    “Sf. Ioan” Emergency Clinical Hospital, Bucharest, Romania
    Department of  General Surgery

  • Violeta Elena COMAN, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania

    Faculty of Medicine Department of Surgery
    “Bagdasar-Arseni” Emergency Clinical Hospital, Bucharest, Romania
    Department of General Surgery

  • Raluca Maria FLOREA, “Sf. Ioan” Emergency Clinical Hospital, Bucharest, Romania

    Department of Gastroenterology

  • A: ERCHILD, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania

    Ph.D. Student, Doctoral School
    “Bagdasar-Arseni” Emergency Clinical Hospital, Bucharest, Romania
    Department of General Surgery

  • V.T. GRIGORESCU, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania

    Faculty of Medicine Department of Surgery
    “Bagdasar-Arseni” Emergency Clinical Hospital, Bucharest, Romania
    Department of General Surgery

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Additional Files

Published

2023-03-31

Issue

Vol. 127 No. 1 (2023): The Medical-Surgical Journal

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SURGERY

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