Duration of Antibiotic Therapy in the Treatment of Severe Postoperative Peritonitis Admitted in ICU

Inclusion Criteria

• •The eligible patients have to fulfill all the following criteria
• •1. patients admitted in intensive care unit
• •2. in the 24 hours following surgery for postoperative intra-abdominal infection (defined as gross pus or purulent effusion within the peritoneal cavity or in one or several collections). Postoperative infection will be defined as an infection observed in a delay of 60 days following a procedure (endoscopy, surgery (abdominal, urologic, gynecologic or vascular surgery or any surgery performed in the peritoneal or retroperitoneal space) or interventional radiology)
• •3. having peroperative microbiologic samples collected
• •4. receiving an empiric antibiotic therapy initiated within the first 24 hours after completion of surgery
• •5. with a written informed consent from the patient or the relative or the legal representative or with an emergency consent
• •Patients with one of the following criteria are eligible for the study :
• •1. age\<18
• •2. pregnancy
• •3. Duration of stay following inclusion \<72 hours
• •4. neutropenia (PMN\<500/mm3) due to chemotherapy or hematological disease
• •5. AIDS stage C
• •6. Immunosuppressive therapy or prolonged steroid therapy (≥0.5 mg/kg/d of prednisone or equivalent \>1 month
• •7. Bowel perforation following endoscopy treated in a delay \<6 hours after injury
• •8. Uterine perforation following a surgical procedure treated in a delay \<6 hours after injury
• •9. Moribund patient (SAPS II score \>65 within 12 hours preceding inclusion)
• •10. Limitation of treatment previously decided
• •11. Surgery considered as non curative by the surgeon
• •12. Patient included in another clinical trial evaluating an antimicrobial agent