Canadian practice guidelines for surgical intra-abdominal infections.

摘要: IAIs remain a major challenge in clinical practice. They are the main cause of postoperative morbidity following abdominal surgery and most frequent for admission to surgical intensive care unit (2,3). differ from infections encountered elsewhere several respects. First, spectrum IAI is extremely wide, ranging uncomplicated acute appendicitis with relatively benign course diffuse peritonitis perforated viscus or ischemic bowel high mortality. While both scenarios comprise IAIs, they require different approaches diagnosis treatment. Additionally, role management patients pivotal generally considered be decisive factor outcome. The microbiological also often problematic: typically polymicrobial, not every microorganism involved can identified microbiology laboratory by routine cultures; pathogenicity certain microorganisms cultured same patient relates more directly severity underlying disease comorbid conditions host; signs symptoms do match may lead substantial delays appropriate (3–8). antibiotic resistance among enteric pathogens has evolved globally at an alarming rate, while very few newer agents have emerged replace older therapeutic regimens. The current practice guideline was jointly developed CSS AMMI Canada. primary goal develop updated recommendations medical complicated since publication 2003 antimicrobial treatment IDSA (1). Particular focus directed risk stratification poor outcomes based on epidemiological studies, status susceptibility profiles pathogens, efficacy regimens randomized trials, operative versus percutaneous source control, IAH ACS infection control preventive measures site infections. An additional objective categorize according strength quality available evidence using standardized grading system. Importantly, provides initial empirical settings issues unique Canadian health system (eg, publicly funded regionalization delivery).