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    What is the appropriate empirical antibiotic treatment for patients diagnosed with Fournier's gangrene? A single tertiary center experience
    (Bayrakol Medical Publisher, 2024) Sahin, Mehmet Fatih; Dogan, Cagri; Ates, Huseyin; Koroglu, Muhammed Sencer; Orbegi, Onur; Akgul, Murat; Yazici, Cenk Murat
    Aim: Fournier's gangrene (FG) is a highly destructive condition characterized by necrotizing fasciitis in the perineal, genital, or perianal area. The primary treatment involves fluid resuscitation, surgical debridement, and broad-spectrum antibiotics. However, there is insufficient evidence regarding antibiotic use in FG. This research aims to assess the microbiological characteristics of FG. Material and Methods: This study covered 40 FG patients from 2010 to 2023. In surgery, all necrotic areas were removed until viable tissue was seen. Primary deformity wound care was performed using vacuum-assisted closure (VAC). Patients with significant issues were evaluated, and plastic surgery was performed to repair the afflicted areas. The research examined FG patients' demographics, clinical features, bacterial cultures, and antibiotic susceptibility to establish the best empirical antibiotic therapy. Results: All patients were male and averaged 66.4 +/- 17.5 years old. The average hospital stay was 13.5 +/- 1.7 days. The median debridement number was 2 (1-4). Despite proper FG therapy, 7 (17.5%) patients died due to multiorgan failure. The wound cultures of 35 individuals (87.5%) showed bacterial growth. In 15 cases (37.5%), Escherichia coli was the most prevalent bacterium, followed by Enterococcus sp., Acinetobacter baumannii, and Streptococcus. Amikacin had the most significant bacterial sensitivity (62.5%), followed by ceftriaxone (60%) and carbapenems (imipenem 57.5%, meropenem 55%). Metronidazole has the greatest bacterial sensitivity (52.5%) among anaerobic bacteria. Discussion: The empirical antibiotherapy of amikacin + metronidazole and ceftriaxone/carbapenem antibiotics shows a notable susceptibility rate. Based on the findings of the culture antibiogram, it is recommended that the antibiotic treatment regimen be modified.