Secondary peritonitis: A study to define the optimal time period of antibiotic treatment.

Background The optimal time period of antibiotic treatment in secondary per itonitis is still unknown. Aim: To prospectively evaluate: 1) The preferred time period of antibiotic treatment in secondary peritonitis by means of a survey applied to a sample of surgeons, and 2) The outcome of a series of patients with secondary per itonitis in whom the length of antibiotic treatment was based on clinical a nd laboratory indicators. Patients and methods: A survey presenting the case of a patient with acute appendicitis and secondary peritonitis was applied to 100 Mexican surgeons. The optimal length of antibiotic treatment in that particular patient was asked. Results were tabulated and analyzed. Subsequently, 35 patients with secondary peritonitis were prospectively evaluated. Antibiotics were discon tinued when. fever relapsed and the white blood count normalized. Clinical characteristics, diagnosis, surgical treatment and outcome we-e analyzed. R ecurrence of sepsis was investigated as the main outcome variable. Results: The survey revealed that 96% surgeons recommended antibiotic treat ment for a period longer than one week. In our study group median age was 3 3 years, 21 were male and 14 female. All patients had a surgical abdominal condition, associated to secondary peritonitis. Median period of antibiotic treatment was 3 days. In a follow-up of one month there was no persistent or recurrent sepsis in any patient. Conclusions: This information may impact in determining the total length of antibiotic therapy if our results are reproduced in studies with more pati ents.