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Cirujano general

versão impressa ISSN 1405-0099

Resumo

SANCHEZ-ESCOBEDO, Yeiscimin; LEON-MORALES, Mónica Isabel  e  RAMIREZ-VEGA, Roberto. Importance of antibiotic therapy in complicated intra-abdominal abscess in patients with acute kidney injury: case reports. Cir. gen [online]. 2020, vol.42, n.4, pp.300-305.  Epub 01-Ago-2022. ISSN 1405-0099.  https://doi.org/10.35366/101399.

Introduction:

When intra-abdominal infections are associated with acute kidney injury, certain modifications are needed in relation to the antimicrobial therapy to be used, since the antibiotic that covers the spectrum of germs involved must also be indicated appropriately and early. The importance of source control has an impact on the decrease in the mortality rate. Description of clinical cases: Five patients having complicated intra-abdominal infection, whose mean age was 55.6 years, 60% of this population were men and 66% presented comorbidities as type two diabetes and systemic arterial hypertension. The clinical presentation most frequent in such subjects was localized pain and fever (75%) and the severity scales of sepsis (average SOFA 15.8 points and AKIN 80% with LRA type III). The most frequently used prophylactic antibiotic in the pre-hospitalization stage was ceftriaxone and, once the antibiogram was performed, it was decided to switch to carbapenems. In days, the mean duration of antimicrobial therapy was 23.4; however, the average hospital stay was 18.2, which suggests a prolonged period of time.

Conclusion:

Sepsis has both high incidence and mortality; therefore, antibiotic treatment should be chosen according to the severity and clinical status, laboratory results and availability of drugs, allowing the medical decision to be based on evidence.

Palavras-chave : Sepsis; intra-abdominal infection; antibiotic therapy; renal disease; acute kidney injury.

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