Risk factors that warrant broad empiric antimicrobial coverage for intra-abdominal infections

Factors associated with mortality

Age >70 years

Medical comorbidity (eg, renal or liver disease, presence of malignancy, chronic malnutrition)

Immunocompromising condition (eg, poorly controlled diabetes mellitus, chronic high-dose corticosteroid use, use of other immunosuppressive agents, neutropenia, advanced HIV infection, B or T leukocyte deficiency)

High severity of illness (ie, sepsis)

Extensive peritoneal involvement or diffuse peritonitis

Delay in initial intervention (source control) >24 hours

Inability to achieve adequate debridement or drainage control

Factors associated with infection with antibiotic-resistant bacteria

Health care-acquired infection

Travel to areas with higher rates of antibiotic-resistant organisms* within the few weeks prior to infection onset or if antibiotics were received during travel

Known colonization with antibiotic-resistant organisms

* High rates of antibiotic resistance have been reported from southeast Asia, east Asia, the Middle East, and Africa.

References:

Solomkin JS, Mazuski JE, Bradley JS, et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis 2010; 50:133.
Woerther PL, Burdet C, Chachaty E, Andremont A. Trends in human fecal carriage of extended-spectrum β-lactamases in the community: toward the globalization of CTX-M. Clin Microbiol Rev 2013; 26:744.

Graphic 105865 Version 3.0

خرید پکیج

Risk factors that warrant broad empiric antimicrobial coverage for intra-abdominal infections