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Volume 37, Issue 2

Original Article

Is Ceftriaxone and Metronidazole Combination Effective in the Empirical Therapy of Intra-Abdominal Infections?

Zekai Serhan Derici
Affiliations
  • Dokuz Eylül Üniversitesi Hastanesi, Genel Cerrahi Anabilim Dalı, İzmir, Türkiye
https://orcid.org/0000-0002-2828-1452
,
Çağlar Irmak
Affiliations
  • Dokuz Eylül Üniversitesi Hastanesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İzmir, Türkiye
https://orcid.org/0000-0002-7901-3757
,
Vildan Avkan-Oğuz
Affiliations
  • Dokuz Eylül Üniversitesi Hastanesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İzmir, Türkiye
https://orcid.org/0000-0001-7648-7730
  • ceftriaxone
  • empiric treatment
  • intra-abdominal infections
  • metronidazol
  • metronidazole

Abstract

Objective: Ceftriaxone and metronidazole (CEF/MET) combination therapy is commonly used in the empirical therapy of intra-abdominal infections (IAIs). We aimed to evaluate the treatment response in patients started on empirical CEF/MET therapy and contribute current treatment data on IAIs.

Methods: A retrospective analysis was conducted on patients receiving parenteral antibiotic therapy in the general surgery department between 2016 and 2018. Patients aged 18 and older who received CEF/MET therapy for more than 24 hours with a diagnosis of IAI were included. Patient characteristics, antibiotic use and/or surgical history in the last three months, infection source, need for surgical intervention, and clinical and laboratory data were evaluated. Treatment response was analyzed in groups of patients with or without treatment changes.

Results: 10,649 patients were evaluated; 591 (5.5%) received CEF/MET therapy, and 297 (50.2%) met the study criteria. Among them, 243 (81.8%) received only CEF/MET treatment (Group 1), while 54 (18.2%) received additional antibiotics (median day 5) (Group 2). Of the patients, 31.6% (94/297) didn’t have an underlying disease, history of antibiotic use, or surgical intervention in the last three months. Only 7.4% underwent treatment modification. A statistically significant relationship was found between data and treatment modification (p=0.001). The gallbladder (63%) or the biliopancreatic tract (12.1%) were the infection foci in 75.1% of all patients. Treatment was modified in 9.6% of the patients with an infection focus in the gallbladder and 55.6% of the patients with an infection focus in the biliopancreatic tract, with a statistically significant difference (p=0.001). Patients with treatment modification had more extended hospital stays and higher mortality rates (p=0.001).

Conclusion: Obtaining information on possible infection sources and patient characteristics in the medical history will contribute to selecting the appropriate antibiotic for empirical treatment and improve treatment success. Empirical therapies that do not require treatment changes will result in shorter hospital stays and reduced mortality.

  • 131-6
  • Çağlar Irmak
  • [email protected]
  • 10.36519/kd.2024.4863
  • January 4, 2024
  • February 5, 2024
  • June 29, 2024

  • Derici ZS, Irmak Ç, Avkan-Oğuz V. [Is ceftriaxone and metronidazole combination effective in the empirical therapy of intra-abdominal infections?]. Klimik Derg. 2024;37(2):131-6. Turkish.
  • 20
  • 10
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  • This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License. CC BY-NC
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