Susceptibility to antibiotics of aerobic bacteria isolated from community acquired secondary peritonitis in children: Therapeutic guidelines might not always fit with and everyday experience

Elio Castagnola, Roberto Bandettini, Francesca Ginocchio, Maddalena Perotti, Daniela La Masa, Antonella Ciucci, Anna Loy, Ilaria Caviglia, Riccardo Haupt, Edoardo Guida, Alessio Pini Prato, Girolamo Mattioli, Piero Buffa

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Appendicitis is a frequent clinical condition in normal children that may be complicated by community-acquired secondary peritonitis (CASP). We evaluated the potential efficacy of different drugs for initial treatment of this condition, as recommended by recent Consensus Conference and Guidelines for paediatric patients. Susceptibility to ampicillin-sulbactam, ertapenem, gentamycin, piperacillin, piper-acillin-tazobactam, vancomycin, and teicoplanin was evaluated according to EUCST 2012 recommenda-tions in aerobic bacteria isolated from peritoneal fluid in CASP diagnosed from 2005 to 2011 at 'Istituto Giannina Gaslini', Genoa, Italy. A total of 114 strains were analysed: 83 E. coli, 15 P. aeruginosa, 6 Enterococci, and 10 other Gram-negatives. Resistance to ampicillin-sulbactam was detected in 37% of strains, while ertapenem showed a potential resistance of 13% (all P. aeruginosa strains). However, the combination of these drugs with gentamicin would have been increased the efficacy of the treatment to 99 and 100%, respectively. Resistance to piperacillin-tazobactam was 3%, while no strain was resistant to meropenem. Our data suggest that monotherapy with ampicillin-sulbactam or ertapenem for community-acquired secondary peritonitis would present a non-negligible rate of failure, but the addition of gentamycin to these drugs could reset to zero this risk. On the contrary, monotherapy with piperacillin-tazobactam or meropenem is highly effective.

Original languageEnglish
Pages (from-to)213-216
Number of pages4
JournalJournal of Chemotherapy
Volume25
Issue number4
DOIs
Publication statusPublished - Aug 2013

Fingerprint

meropenem
Aerobic Bacteria
Gentamicins
Peritonitis
Guidelines
Anti-Bacterial Agents
Piper
Teicoplanin
Piperacillin
Ascitic Fluid
Enterococcus
Appendicitis
Drug Combinations
Vancomycin
Pharmaceutical Preparations
Italy
Therapeutics
Pediatrics
Escherichia coli
sultamicillin

Keywords

  • Children
  • Community-acquired secondary peritonitis
  • Susceptibility antibiotic aerobic bacteria

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases
  • Oncology
  • Pharmacology

Cite this

Susceptibility to antibiotics of aerobic bacteria isolated from community acquired secondary peritonitis in children : Therapeutic guidelines might not always fit with and everyday experience. / Castagnola, Elio; Bandettini, Roberto; Ginocchio, Francesca; Perotti, Maddalena; La Masa, Daniela; Ciucci, Antonella; Loy, Anna; Caviglia, Ilaria; Haupt, Riccardo; Guida, Edoardo; Prato, Alessio Pini; Mattioli, Girolamo; Buffa, Piero.

In: Journal of Chemotherapy, Vol. 25, No. 4, 08.2013, p. 213-216.

Research output: Contribution to journalArticle

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abstract = "Appendicitis is a frequent clinical condition in normal children that may be complicated by community-acquired secondary peritonitis (CASP). We evaluated the potential efficacy of different drugs for initial treatment of this condition, as recommended by recent Consensus Conference and Guidelines for paediatric patients. Susceptibility to ampicillin-sulbactam, ertapenem, gentamycin, piperacillin, piper-acillin-tazobactam, vancomycin, and teicoplanin was evaluated according to EUCST 2012 recommenda-tions in aerobic bacteria isolated from peritoneal fluid in CASP diagnosed from 2005 to 2011 at 'Istituto Giannina Gaslini', Genoa, Italy. A total of 114 strains were analysed: 83 E. coli, 15 P. aeruginosa, 6 Enterococci, and 10 other Gram-negatives. Resistance to ampicillin-sulbactam was detected in 37{\%} of strains, while ertapenem showed a potential resistance of 13{\%} (all P. aeruginosa strains). However, the combination of these drugs with gentamicin would have been increased the efficacy of the treatment to 99 and 100{\%}, respectively. Resistance to piperacillin-tazobactam was 3{\%}, while no strain was resistant to meropenem. Our data suggest that monotherapy with ampicillin-sulbactam or ertapenem for community-acquired secondary peritonitis would present a non-negligible rate of failure, but the addition of gentamycin to these drugs could reset to zero this risk. On the contrary, monotherapy with piperacillin-tazobactam or meropenem is highly effective.",
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AU - Bandettini, Roberto

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AU - Perotti, Maddalena

AU - La Masa, Daniela

AU - Ciucci, Antonella

AU - Loy, Anna

AU - Caviglia, Ilaria

AU - Haupt, Riccardo

AU - Guida, Edoardo

AU - Prato, Alessio Pini

AU - Mattioli, Girolamo

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