Pattern of antibiotic therapy and clinical outcome in acute generalized peritonitis in semi-urban and rural Nigerians

• Published in: Chemotherapy (Basel) Vol. 52; no. 2; p. 69
• Main Authors: Adesunkanmi, A R K, Badmus, T A
• Format: Journal Article
• Language: English
• Published: Switzerland 01-01-2006
• Subjects: Acute Disease; Adolescent; Adult; Aged; Anti-Bacterial Agents - therapeutic use; Child; Child, Preschool; Drug Utilization; Female; Humans; Infant; Male; Middle Aged; Nigeria - epidemiology; Peritonitis - drug therapy; Peritonitis - epidemiology; Peritonitis - etiology; Postoperative Complications - diet therapy; Practice Patterns, Physicians; Prospective Studies; Rural Population; Treatment Outcome; Urban Population; Nigeria
• ISSN: 0009-3157
• DOI: 10.1159/000092370

To determine the pattern of antibiotic therapy and clinical outcome a prospective survey of all patients operated on for acute generalized peritonitis was undertaken. The male to female ratio was 1.7:1, and the mean age was 27.6 +/- 18.3 years. Operative findings were typhoid ilea perforation in 75 (38.1%), complicated acute intestinal obstruction in 44 (22.3%), complicated and uncomplicated acute appendicitis in 34 (17.3%), peptic ulcer perforation in 18 (9%) and traumatic intestinal injury in 11 (5.6%), representing the majority of the patients. A combination of chloramphenicol, gentamicin and metronidazole was given to 80 (40.6%), ampiclox, gentamicin and metronidazole to 72 (36.5%), ampiclox and gentamicin to 21 (10.6%) and other combinations to 5. A single antibiotic was administered in 13 (6.6%), that is clavulanate-amoxicillin, ampiclox, and cefuroxime. Antibiotics were changed in 37 patients (18.8%): to amoxicillin-clavulanate in 13, cefuroxime in 11, ceftriazone in 7, cefuroxime and metronidazole in 4 and amoxicillin-clavulanate and metronidazole in 2 patients. Postoperative complications were mainly wound infection in 105 (42.6%), wound dehiscence in 33 (16.7%), residual intra-abdominal sepsis in 19 (9.6%), residual intra-abdominal abscess in 17 (8.6%), postoperative chest infection in 14 (7%), incisional hernia in 11 (5.6%), anaemia in 6, faecal fistula in 5 and there was a mortality of 15.7%.