intra-abdominal%20infections
INTRA-ABDOMINAL INFECTIONS
Intra-abdominal infections (IAI) occur due to disruption of the normal anatomic barrier.
In the hollow viscera is where common disruptions occur, which allows intraluminal bacteria to invade and proliferate in the usually sterile area (ie peritoneal cavity or retroperitoneum).
Community-acquired intra-abdominal infection is usually secondary to gastroduodenal perforation, ascending cholangitis, cholecystitis, appendicitis, colon diverticulitis with or without perforation, or pancreatitis.
Uncomplicated IAI infectious process involves only a single organ and does not extend to the peritoneum.
Complicated IAI is when infection extends beyond the hollow viscus of origin into the peritoneal space and may be associated with peritonitis or abscess formation.

Management of Treatment Failure

  • Computed tomography (CT) scan or ultrasound imaging should be done to patients who show persistent or recurrent clinical evidence of intra-abdominal infections (IAI) after 4-7 days of treatment
  • If the patient is not improving w/ the microbiologically adequate initial empiric therapy, alternative diagnosis (eg extra-abdominal sources or noninfectious inflammatory conditions) should be considered
  • Aerobic & anaerobic cultures from 1 specimen of sufficient amount (at least 1 mL of fluid or tissue) should be obtained from patients who do not respond initially & from whom focus of infection remains
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