journal algérien de médecine
Volume 26, Numéro 3, Pages 31-40
2018-06-30
Probabilistic Antibiotic Therapy In The Fournier’s Gangrene Our Experience On 320 Cases
Authors : Rahal-benchouk Jazia A. . Merbouh M.a. . Benkada M.b. . Taleb A . Said F . Messaad M . Maghraoui S .
Abstract
Introduction : Fournier’s gangrene (FG) is an acute and devastating illness that affects the perineum and external genitalia. Its treatment is based on an early and extensive debridement and on a probabilistic broad spectrum antibiotherapy covering the aero–anaerobic organisms. The aim’s study is to compare the mortality, the hospitalization delay and the main prognostic predictors between two groups of patients whether if they received or not targeted antibiotic therapy. Patients and methods : It’s a retrospective study of 320 patients divided in two groups. G1 : targeted antibiotic therapy (n = 20) and G2 : broad spectrum antibiotic therapy (n = 300). Collected data were related to the mortality, time admission, physical examination, etiologies, comorbidities, pre – and post–admission treatments and debridement frequency. Results : The overall mortality rate was 18.4 % (n = 59). It was 30 % (n = 6) in G1 and 17.7 % (n = 53) in G2 (NS). The mean of post–admission debridement was 5, 35 ± 1.81 in G1 and 4. 68 ± 1. 89 in G2 (NS) The hospitalization delay was 42 ± 19 and 42. 18 ± 16, 84 days in respectively G1 and G2 (NS). For the G1, flora was polymicrobial (75 %), monomicrobial (15 %) ; no growth (10 %). Conclusion : broad spectrum antibiotherapy retains its place in the treatment of FG. Its adaptation had no influence on mortality or on prognostic factors compared to the targeted one. It remains an excellent option for centers with high recruitment and low means.
Keywords
Fournier’s Gangrene, Poly–microbial flora, Broad spectrum antibiotherapy, Targeted antibiotherapy.
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