SPAC is a pilote monocentric prospective study about peritonitis and antibiotics pharmacokinetic and pharmacodynamic. The investigators will included 50 patients during 2 years in the University Hospital of Nancy. The aim of this study is to determine if the beta-lactam dosages recommended by the guidelines for management of intra-abdominal infections (published by the Société française d'anesthésie et de réanimation (Sfar) in december 2015) permitted the achievement of adequatly serum and peritoneal concentrations in the medical and surgical management of peritonitis. The investigators will collected 3 pairs of serum and peritoneal fluid samples at 3 different times: peritoneal incision, arrival in ICU and 24 hours after admission in ICU in order to compare the concentrations and the minimal inhibitor concentration of bacteria. The hypothesis is that of a serum and peritoneal antibiotic under dosage.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
50
Dosage of serum and peritoneal of the B lactam used B lactam concerning are : CEFTRIAXONE, CEFOTAXIME, PIPERACILLINE/TAZOBACTAM, IMIPENEM
Central Hospital
Vandœuvre-lès-Nancy, France
RECRUITINGSerum and peritoneal beta lactams concentrations at 3 times
Population : patients with surgical peritonitis. The concentrations are compared with the minimum inhibitory concentrations of bacteria to diagnose a sub therapeutic dosage.
Time frame: 3 times : Peritoneal incision, Admission in ICU and 24 hours after admission in ICU
Factors associated with an antibiotic under-dosage
effect of presence of septic shock on antibiotic concentration
Time frame: Statistical analysis after 2 years of inclusion
Factors associated with an antibiotic under-dosage
effect of volume ressucitation on antibiotic concentration
Time frame: Statistical analysis after 2 years of inclusion
Factors associated with an antibiotic under-dosage
effect of renal function on antibiotic concentration
Time frame: Statistical analysis after 2 years of inclusion
Evaluate the relationship between serum and peritoneal concentrations of beta-lactam
Determination of the antibiotic diffusion coefficient through the peritoneal membrane : difference between serum concentration and peritoneal concentration of B lactam
Time frame: Statistical analysis after 2 years of inclusion
Morbidity of included patients
Morbidity is assessed by the presence or absence of second peritonitis surgery during hospitalization in ICU and at most 8 days (the mean of the peritonitis stays in the ICU of the investigators in 2016 is 8 days)
Time frame: Reception on the 8th postoperative day
Mortality of included patients
The mortality is evaluated by the presence or absence of the death of the patient during the hospitalization in ICU and at most 8 days
Time frame: Reception on the 8th postoperative day
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