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Master Thesis

Une antibiothérapie par amoxicilline-acide clavulanique est-elle adaptée dans le traitement probabiliste des infections intra abdominales communautaires ?

Abstract : Background: complicated intra-abdominal infections (IAI) represent a wide spectrum of pathologies whose treatment combines surgical management and probabilistic antibiotic therapy. As with all infections, the bacteria responsible are subject to resistance, particularly enterobacteria. Therefore, the changing epidemiology of the microorganisms in IAI requires active surveillance through microbiological profiling and susceptibility testing. The main objective of this work was to determine the ecology of community-acquired IAI in order to assess the susceptibility of these infections to probabilistic antibiotic therapy with amoxicillin-clavulanic acid (ACA). The secondary outcomes was to assess the incidence of Entobacteriaceae résistant to ACA, the proportion of appropriate empirical treatment and risk factors for resistance to ACA. Methods: this was a retrospective, monocentric, 5-year study in Bordeaux University Hospital that included all patients admitted for community complicated IAI and receiving empirical antibiotic therapy and intraoperative specimens. The primary endpoint was the susceptibility of enterobacteria to probabilistic ACA in surgical community IAI. Results: one hundred and forty-four patients were included in the study, 67 of whom are considered resistant to ACA, 346 pathogens were identified. Gram-negative bacteria represented the most frequently isolated germs (n=195) with, in order, Escherichia coli (n=122) then Pseudomonas aeruginosa (n=22). Then we found Gram-positive cocci (n=95) dominated by streptococci (n=71) then anaerobes (n=46). Probabilistic antibiotic therapy was appropriate in 86 patients (59.7%). Among enterobacteria, 67.3% were susceptible to ACA and Escherichia coli had a sensitivity estimated at 70.2%. Conclusion: ACA does not seem to be adapted in the empirical management of community surgical IAI.
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https://dumas.ccsd.cnrs.fr/dumas-03110300
Contributor : Médecine Ub <>
Submitted on : Thursday, January 14, 2021 - 2:33:37 PM
Last modification on : Tuesday, February 2, 2021 - 3:12:13 AM
Long-term archiving on: : Thursday, April 15, 2021 - 6:59:45 PM

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  • HAL Id : dumas-03110300, version 1

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Émilie Labarchède. Une antibiothérapie par amoxicilline-acide clavulanique est-elle adaptée dans le traitement probabiliste des infections intra abdominales communautaires ?. Sciences du Vivant [q-bio]. 2020. ⟨dumas-03110300⟩

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