Characterisation and Safety of Intraperitoneal Perioperative Administration of Antibacterial Agents: A Systematic Review

Siv Fonnes; Barbara Juliane Holzknecht; Magnus Arpi; Jacob Rosenberg

doi:10.1055/s-0043-109565

Drug Research, Inhaltsverzeichnis

Drug Res (Stuttg) 2017; 67(12): 688-697
DOI: 10.1055/s-0043-109565

Original Article

Characterisation and Safety of Intraperitoneal Perioperative Administration of Antibacterial Agents: A Systematic Review

Siv Fonnes

¹Centre for Perioperative Optimisation, Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark

,

Barbara Juliane Holzknecht

²Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark

,

Magnus Arpi

²Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark

,

Jacob Rosenberg

¹Centre for Perioperative Optimisation, Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark

› Institutsangaben

Abstract

Background Intraperitoneal drug administration applies treatment at the site of diseases with gynaecological, urological, or gastrointestinal origin. The objective of this systematic review was to investigate perioperative intraperitoneal administration of antibacterial agents to characterise the drugs used and their safety profile.

Methods A protocol was registered at PROSPERO (CRD42016038956). A systematic review was conducted and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A search was performed in PubMed and EMBASE on the 22^nd of April 2016. The inclusion criteria were original articles involving at least 5 patients where antibacterial agents were administered intraperitoneally during or after abdominal surgery as prophylaxis or treatment of infection. Languages were limited to English, German, Danish, Norwegian, or Swedish articles.

Results 79 studies were included which used a total of 12 different antibacterial classes. Aminoglycosides, 1^st and 2^nd generation cephalosporins, tetracyclines, and penicillins were most commonly administered intraperitoneally during or after surgery. The antibacterial agent was usually administered intraperitoneally as monotherapy. However, some studies administered combination regimens with heparin or with another antibacterial agent. The most frequent combination was aminoglycosides and lincosamides. In total, 43% of studies lacked information regarding adverse events. The most frequently reported adverse event was discomfort or pain during administration, especially with use of oxytetracycline.

Conclusion At least 12 different classes of antibacterial agents have been administered intraperitoneally during or after surgery as prophylaxis or treatment of intraabdominal infections. Intraperitoneal administration seems safe although use of oxytetracycline may cause discomfort or pain.

Key words

antibacterial drugs - drug delivery - clinical trials

Volltext

Referenzen

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