Antibiotic Use in The Open Abdomen

Abstract

Bakground: The duration of antibiotics for patients managed with an open abdomen (OA) has not been well defined. We hypothesized that short course (SC) antimicrobial therapy is superior to long course (LC) in non-traumatic, OA management. Methods: A retrospective review of emergency surgery patients (non-trauma), managed with an OA from 6/2013 to 6/2014 was performed. The primary outcome was SSI and all other in-hospital infections.Patients were divided into SC antibiotics ( 7 days), and LC ( > 7 days). Results: 87 patients met inclusion criteria for the study: 25 patients had a SC of antibiotics, 62 had LC. The median duration of antibiotic therapy was 17 days, with a median of 5 days (IQR 3-6) in the SC group, compared to 23.5 days in the LC group (IQR 16-38). Median days of OA were 3 days in the SC (IQR1-4) and 4 days in the LC (IQR 2-8). There was a 16% incidence of secondary infection (pneumonia, Clostridium Difficile, UTI, and Bacteremia) in the SC group, compared to 56% in the LT group. Conclusion: In the current population of non-trauma patients managed with an OA, those that received SC antibiotics had less secondary infections than those with LC. Keywords: Open Abdomen; Antibiotics use in open abdomens; Secondary infections