Prospective Study to Identify Commonest Organisms and Antibiotic Sensitivity in Peritonitis Due to Duodenal Ulcer Perforation in Govt. Rajaji Hospital
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 3
Abstract
Perforative peritonitis is one of the most commonly encountered surgical acute abdominal emergencies in surgery casuality. The importance of this study is to reduce the postoperative complications like septicemia, wound infection, burst abdomen, bronchopneumonia, long hospital stay etc., by identifying the inciting organisms and its sensitive antibiotics rather than using empirical antibiotic therapy which is followed at present, in immediate postoperative period. Among hollow viscus perforations duodenal perforation is the most common site. The organisms setting up the peritonitis features are diverse according to the location of perforation. The common organisms isolated in proximal bowel perforation are E.coli, klebsiella, lactobacilli, streptococci, candida. There is an increasing trend in isolating anaerobic organisms or polymicrobial isolates as the perforation occurs distally and the time interval between the disease onset and time of intervention increases. Majority of rural patients present in surgical opd lately. Also there is a direct relation between interval of disease onset & time of intervention and postoperative morbidity. In proximal bowel perforation, proposed antibiotic coverage is against gram positive cocci and gram negative enteric organisms. Hence administration of appropriate antibiotics in immediate postoperative period reduces poor postoperative outcome.
Authors and Affiliations
Dr. C. Gangalaksmi, Dr. R. Tennison Post Graduate, Department of General Surgery, Madurai Medical College, Madurai, Tamilnadu, India.
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