Perfil bacteriológico y esquemas antibióticos utilizados para el tratamiento de la gangrena de Fournier

Abstract

Objective: to determine the bacteriological profile and the antibiotic regimens used for the treatment of Fournier's gangrene. Method: A Literature Review was conducted. Articles were selected from the following databases: ProQuest (https://www.proquest.com/), PubMed (https://pubmed.ncbi.nlm.nih.gov/), and ScienceDirect (https://www.sciencedirect.com/) in Spanish or English, using descriptors and Boolean operators AND and OR. Results: The bacteriological profile of Fournier's gangrene is mainly of the polymicrobial type, with a greater presence of gram-negative and anaerobic bacteria, among which the most important are Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae and Bacteroides fragilis. The most prominent gram-positive bacteria are Staphylococcus aureus and Streptococcus spp. There are also multiresistant bacteria, mainly Escherichia coli blee and methicillin-resistant Staphylococcus aureus. As for treatment, there are multiple antibiotic regimens, the most widely used and recommended being: third generation cephalosporin plus aminoglycoside plus metronidazole. Conclusion: Fournier's gangrene is a rare but very devastating pathology that is difficult to treat and has a poor prognosis. The infection is mainly polymicrobial and the antibiotic treatment required is broad spectrum.