Intra-Abdominal Infections
Intra-Abdominal Infections
Jessica Thompson, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Clinical Specialist
Renown Health April 19, 2018
Select guidelines
? Mazuski JE, et al. The Surgical Infection Society revised guidelines on the management of intra-abdominal infection. Surgical Infections 2017; 18: 1-76.
? Stollman N, et al. American Gastroenterological Association Institute guideline on the management of acute diverticulitis 2015; 149: 19441949.
? Solomkin, et al. Diagnosis and management of complicated intraabdominal infection in adults and children: guidelines by the Surgical Infection Society and Infectious Diseases Society of America. Clinical Infectious Diseases 2010; 50:133-164.
? IDSA: "Update in Progress"
Intra-abdominal infection (IAI)
? Infection of any of the organs or organ spaces in the abdominal cavity
? Lower part of the esophagus ? Stomach ? Intestines (small and large) ? Colon ? Rectum ? Gall bladder ? Spleen
Intra-abdominal infection
Uncomplicated
? Infection contained within a single organ (stomach, gallbladder, intestines, etc) without anatomic disruption
? May or may not require surgical management
Complicated
? Infection extends beyond the organ with spillage of microorganisms into normally sterile space
? Primary management is oftentimes source control
Common pathogens
? Most common
? E.coli
Empiric treatment
? Bacteroides species
? Other common pathogens
? Other Enterobacteriaceae ? Streptococcus species
of communityonset IAI should
target these organisms
Empiric treatment of hospital-onset IAI should target
? Clostridial species
these organisms
? Hospital-associated or tertiary peritonitis pathogens
? Pseudomonas aeruginosa
? Enterococcus species
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