ORIAMIORal Antibiotics in Acute Mesenteric Ischemia: a Multicenter Randomized Controlled Trial

Study start date: January 31, 2025

Inclusion Criteria: * Adult patient aged 18 and less 90 * AMI of arterial occlusive origin, defined by the combination of 1. Onset \< 7 days of clinical, biological and/or radiological signs of acute intestinal injury in the territory of at least superior mesenteric ischemia, including right-side colitis, 2. significant vascular obstruction \> 75% of the superior mesenteric artery, and 3. no alternative diagnosis * Admitted to the SURVI care network (Beaujon Hospital intensive care unit or SURVI, Bichat intensive care unit or vascular surgery department) Exclusion Criteria: * Other forms of mesenteric ischemia (chronic without acute manifestations, venous, non-occlusive, strangulation, aortic dissection) * Isolated left-side ischemic colitis * Mesenteric vascular lesion without small bowel injury or right colon * Not eligible for vascular or digestive surgery or intensive care (palliative context) * Indication for an emergency surgical intestinal resection at the admission to the SURVI care network * Indication for urgent systemic antibiotic treatment on admission (evidence of sepsis defined as a SOFA score of 2 or more associated with an infection) * Systemic or oral antibiotic therapy within 7 days before inclusion * Known hypersensitivity to the active substance /excipients * Contraindications to the investigational medicinal products (gentamicin, metronidazole) * Unable to give consent (under guardianship or curatorship) * Subject deprived of freedom, subject under a legal protective measure * Patient refusal to participate * Non-affiliation to a social security regimen or CMU * Patient under State Medical Aid * Pregnant or breastfeeding women * Participation in another clinical study involving investigational medicinal product or patient being in the exclusion period at the end of a previous study