Intra-abdominal infection: Difference between revisions
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* [[Peritonitis]] |
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* [[Liver abscess]] |
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== |
== Management == |
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* Source control (either surgical or by interventional radiology) is the primary treatment modality, along with adjunctive antibiotics |
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* [Spontaneous bacterial peritonitis (SBP)](Spontaneous bacterial peritonitis (SBP).md) |
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**Abscesses less than 3 to 6 cm may be treatable with medication alone, without drainage |
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*For uncomplicated infections or infections with good source control, 3 to 5 days of antibiotics following source control is reasonable |
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== Secondary peritonitis == |
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* Consider empiric coverage for [[Candida]] with nosocomial infections, particularly in patients with recent abdominal surgery or anastomotic leak |
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* Secondary to trauma or perforation |
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* See also STOP IT trial for 4+/-1 days of antibiotics after source control |
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== Tertiary peritonitis == |
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* Ongoing intraabdominal sepsis after appropriate treatment of secondary peritonitis |
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* Organisms include resistant Gram-positives (Enterococcus, coagulase-negative Staphylococci), resistant Gram-negatives (ESBLs), and Candida |
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* Can also be aseptic without infection but with ongoing inflammation |
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== Peritoneal dialysis-related peritonitis == |
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= Pyogenic Liver Abscess = |
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* Get source control |
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* Treat for 4-6 weeks, ensuring radiological resolution of abscess |
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* [https://doi.org/10.1155/2010/580340 Canadian practice guidelines for surgical intra-abdominal infections]. ''Can J Infect Dis Med Microbiol''. 2010;21(1):11–37. |
* [https://doi.org/10.1155/2010/580340 Canadian practice guidelines for surgical intra-abdominal infections]. ''Can J Infect Dis Med Microbiol''. 2010;21(1):11–37. |
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*The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intraabdominal infections. ''World J Emerg Surg.'' 2017;12:29. doi: [https://doi.org/10.1186/s13017-017-0141-6 10.1186/s13017-017-0141-6] |
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[[Category:Intra-abdominal infections]] |
[[Category:Intra-abdominal infections]] |
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Latest revision as of 14:43, 10 March 2022
Management
- Source control (either surgical or by interventional radiology) is the primary treatment modality, along with adjunctive antibiotics
- Abscesses less than 3 to 6 cm may be treatable with medication alone, without drainage
- For uncomplicated infections or infections with good source control, 3 to 5 days of antibiotics following source control is reasonable
- Consider empiric coverage for Candida with nosocomial infections, particularly in patients with recent abdominal surgery or anastomotic leak
Further Reading
- Canadian practice guidelines for surgical intra-abdominal infections. Can J Infect Dis Med Microbiol. 2010;21(1):11–37.
- The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intraabdominal infections. World J Emerg Surg. 2017;12:29. doi: 10.1186/s13017-017-0141-6
