Duration of antibiotic treatment in surgical infections of the abdomen. The role of shock.

Abstract

Emergency laparotomy requiring perioperative antibiotics is often accompanied by shock. Whether the shock is the result of haemorrhage, sepsis, cardiac disease, or vasodilatation, it represents a profound metabolic alteration which impairs cellular metabolism, causes immunosuppression, and alters pharmacokinetics. These changes lead to an increased risk of infection, which can be overcome, at least in part, by increasing the dose and (probably) the duration of perioperative antibiotics.