The role of beta-lactam antimicrobials as single agents in treatment of intra-abdominal infection.

Abstract

Broad-spectrum beta-lactam antibiotics have several advantages in the treatment of intra-abdominal infections. These agents are effective against gram-negative rods and anaerobes, reach therapeutic levels rapidly after parenteral administration, and, in the absence of penicillin allergy, generally exhibit low toxicity. The second-generation cephalosporins (e.g., cefoxitin, cefotetan) are used widely in surgical prophylaxis, trauma, and treatment of mild-to-moderate community-acquired infections, but limitations in their spectra and microbial resistance restrict their utility in more serious infections. Extended-spectrum penicillin/beta-lactamase-inhibitor combinations are effective in the treatment of intra-abdominal infections and include enterococci in their spectrum. Gram-negative aerobe resistance has developed to ampicillin/sulbactam. Piperacillin/tazobactam, a ureidopenicillin with increased gram-negative coverage and enhanced antipseudomonal activity, has proved to be effective in clinical trial therapy for intra-abdominal infections. The very broad spectrum carbapenems--imipenem/cilastatin and meropenem--are effective for serious infections or resistant organisms and are often used in the intensive care unit or for nosocomial intra-abdominal infection. These classes of beta-lactams comprise a range of antimicrobials that can be targeted effectively as single agents to both prevention and treatment of intra-abdominal infection.

• Authors: L L Powell, S E Wilson
• Journal: Surgical infections (Surg Infect (Larchmt)) Vol. 1 Issue 1 Pg. 57-63 ( 2000) ISSN: 1096-2964 [Print] United States
• PMID: 12594910 (Publication Type: Journal Article, Review)

Chemical References

• Anti-Bacterial Agents
• Carbapenems
• Cephalosporins
• Clavulanic Acids
• Enzyme Inhibitors
• beta-Lactamase Inhibitors
• Piperacillin, Tazobactam Drug Combination
• sultamicillin
• Ampicillin
• ticarcillin-clavulanic acid
• Penicillanic Acid
• Ticarcillin
• Sulbactam
• Piperacillin

Topics

• Abdomen
• Abdominal Abscess (drug therapy, prevention & control)
• Ampicillin (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Bacterial Infections (drug therapy, prevention & control)
• Carbapenems (therapeutic use)
• Cephalosporins (therapeutic use)
• Clavulanic Acids (therapeutic use)
• Drug Resistance, Bacterial
• Drug Therapy, Combination (therapeutic use)
• Enzyme Inhibitors (therapeutic use)
• Humans
• Penicillanic Acid (analogs & derivatives, therapeutic use)
• Piperacillin (therapeutic use)
• Piperacillin, Tazobactam Drug Combination
• Sulbactam (therapeutic use)
• Surgical Wound Infection (drug therapy, prevention & control)
• Ticarcillin (therapeutic use)
• beta-Lactamase Inhibitors