Complicated intraabdominal infections in surgical patients - empiric antimicrobial therapy management
Abstract
Any intraabdominal infection (IAI) is a complex disease that requires an assessment of a number of various aspectsimportant for determining proper therapeutic management, including an appropriate antimicrobial regimen. Current classifications of intraabdominal infections recognize various types of peritonitides (primary, secondary, tertiary); however, for clinical needs the cases are most commonly divided as non-complicated and complicated intraabdominal infections.
In any intraabdominal infection, the surgical intervention includes perioperative empiric choice of antibiotics, which should take into account - in addition to the severity level of the infection - the epidemiological situation and risk factors of the presence of resistant bacteria in the patient. The article presents a current overview of the choice of antimicrobial agents indicated in individual groups of intraabdominal infections (biliary, extrabiliary) caused by community-acquired or hospital-acquired pathogens.
Recent guidelines for choosing antimicrobial drugs against multiresistant bacteria provide very important information, particularly with respect to the increasing incidence of multiresistant strains as causal agents of intraabdominal infections in surgical patients. However, surgical departments need to be familiar with current sensitivity of pathogens in order to provide individualized antimicrobial therapy via empiric administration.