Empiric Antimicrobial Treatment of Anastomotic Leakage after Esophageal Resection: The Most Commonly Used Antimicrobial Regimens in the Netherlands and an Antimicrobial Treatment Recommendation Based on a Single-Center Population

Based on the studied cultures, empiric antibiotics should cover Gram-positive, Gram-negative, anaerobe bacteria and Pseudomonas. We recommend the use of empiric amoxicillin/clavulanic acid with tobramycin for patients with AL after esophagectomy, which is now protocol in our center. The addition of antifungals remains debatable. Given the high incidence of yeast-positive cultures in the studied cohort, we recommend the addition of an echinocandin in clinically unstable patients.