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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Peritonitis | Other | Patient received for antibiotic treatment a B lactam according to French recommendation :
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dosage of serum and peritoneal of the B lactam used for antibiotic treatment | Other | Dosage of serum and peritoneal of the B lactam used B lactam concerning are : CEFTRIAXONE, CEFOTAXIME, PIPERACILLINE/TAZOBACTAM, IMIPENEM |
| Measure | Description | Time Frame |
|---|---|---|
| Serum 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. | 3 times : Peritoneal incision, Admission in ICU and 24 hours after admission in ICU |
| Measure | Description | Time Frame |
|---|---|---|
| Factors associated with an antibiotic under-dosage | effect of presence of septic shock on antibiotic concentration | Statistical analysis after 2 years of inclusion |
| Factors associated with an antibiotic under-dosage |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Emmanuel NOVY, MD | Contact | +33 3157437 | e.novy@chru-nancy.fr | |
| El Mehdi SIAGHY | Contact | +33 3155276 | m.siaghy@chru-nancy.fr |
| Name | Affiliation | Role |
|---|---|---|
| Emmanuel NOVY, MD | CHRU NANCY | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Central Hospital | Recruiting | Vandœuvre-lès-Nancy | 54500 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31599951 | Derived | Leon L, Guerci P, Pape E, Thilly N, Luc A, Germain A, Butin-Druoton AL, Losser MR, Birckener J, Scala-Bertola J, Novy E. Serum and peritoneal exudate concentrations after high doses of beta-lactams in critically ill patients with severe intra-abdominal infections: an observational prospective study. J Antimicrob Chemother. 2020 Jan 1;75(1):156-161. doi: 10.1093/jac/dkz407. |
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| ID | Term |
|---|---|
| D010538 | Peritonitis |
| D016638 | Critical Illness |
| ID | Term |
|---|---|
| D059413 | Intraabdominal Infections |
| D007239 | Infections |
| D010532 | Peritoneal Diseases |
| D004066 | Digestive System Diseases |
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effect of volume ressucitation on antibiotic concentration
| Statistical analysis after 2 years of inclusion |
| Factors associated with an antibiotic under-dosage | effect of renal function on antibiotic concentration | 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 | 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) | 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 | Reception on the 8th postoperative day |
| D020969 |
| Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |