Review of the guidelines for complicated skin and soft tissue infections and intra-abdominal infections–are they applicable today?

August 10, 2016 at 8:34 am

Clin Microbiol Infect. 2008 Dec;14 Suppl 6:9-18.

Caínzos M1.

Author information

1Hospital Clínico Universitario, Medical School, Santiago de Compostela, Spain. ci28@usc.es

Abstract

Difficult-to-treat infections in surgical patients, such as serious skin and soft tissue infections (SSTIs) and complicated intra-abdominal infections (cIAIs), are the cause of significant morbidity and mortality, and carry an economic burden. These surgical site infections are typically polymicrobial infections caused by a plethora of pathogens, which include difficult-to-treat organisms and multiresistant Gram-positive and Gram-negative strains. Optimal management of SSTIs and cIAIs must take into account the presence of resistant pathogens, and depends on the administration of appropriate antimicrobial therapy (i.e. the correct spectrum, route and dose in a timely fashion for a sufficient duration as well as the timely implementation of source control measures). Treatment recommendations from the Infectious Diseases Society of America and the Surgical Infection Society are available for guidance in the management of both of these infections, yet the increased global prevalence of multidrug-resistant pathogens has complicated the antibiotic selection process. Several pathogens of concern include methicillin-resistant Staphylococcus aureus, responsible for problematic postoperative infections, especially in patients with SSTIs, extended-spectrum beta-lactamase-producing Gram-negative bacteria, including CTX-M-type-producing Escherichia coli strains, and multidrug-resistant strains of Bacteroides fragilis. New empirical regimens, taking advantage of potent broad-spectrum antibiotic options, may be needed for the treatment of certain high-risk patients with surgical site infections.

FULL TEXT

http://www.sciencedirect.com/science/article/pii/S1198743X1461260X

PDF

http://ac.els-cdn.com/S1198743X1461260X/1-s2.0-S1198743X1461260X-main.pdf?_tid=66650bd4-58c8-11e6-9a3a-00000aacb35f&acdnat=1470153021_13a0055e9d7f7f6dee0fc76a87714ee8

Entry filed under: CONSENSOS, GUIDELINES, Infecciones en piel y tej blandos, Infecciones intraabdominales, Metodos diagnosticos, REVIEWS, Sepsis. Tags: .

Treatment Modalities and Antimicrobial Stewardship Initiatives in the Management of Intra-Abdominal Infections. Antimicrobial susceptibility of Gram-negative bacilli of community acquired intra-abdominal infections in a hospital at Buenos Aires, Argentina.


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