Intra-abdominal infection: Difference between revisions

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* [[Peritonitis]]
= Intra-abdominal infections =
* [[Liver abscess]]


== Peritonitis ==
== Management ==


* Source control (either surgical or by interventional radiology) is the primary treatment modality, along with adjunctive antibiotics
=== Primary peritonitis ===
**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
* [Spontaneous bacterial peritonitis (SBP)](Spontaneous bacterial peritonitis (SBP).md)
* Consider empiric coverage for [[Candida]] with nosocomial infections, particularly in patients with recent abdominal surgery or anastomotic leak

=== Secondary peritonitis ===

* Secondary to trauma or perforation
* See also STOP IT trial for 4+/-1 days of antibiotics after source control

=== Tertiary peritonitis ===

* Ongoing intraabdominal sepsis after appropriate treatment of secondary peritonitis
* Organisms include resistant Gram-positives (Enterococcus, coagulase-negative Staphylococci), resistant Gram-negatives (ESBLs), and Candida
* Can also be aseptic without infection but with ongoing inflammation

=== Peritoneal dialysis-related peritonitis ===

== Pyogenic Liver Abscess ==

* Get source control
* Treat for 4-6 weeks, ensuring radiological resolution of abscess


== Further Reading ==
== Further Reading ==
* [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.
*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]


[[Category:Intra-abdominal infections]]
* [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.

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