Abstract:
Intra-abdominal infections (IAIs) are an important cause of morbidity and mortality in hospital settings worldwide. The cornerstones of IAI management include rapid, accurate diagnostics; timely, adequate source control; appropriate, short-duration antimicrobial therapy administered according to the principles of pharmacokinetics/pharmacodynamics and antimicrobial stewardship; and hemodynamic and organ functional support with intravenous fluid and adjunctive vasopressor agents for critical illness (sepsis/organ dysfunction or septic shock after correction of hypovolemia). In patients with IAIs, a personalized approach is crucial to optimize outcomes and should be based on multiple aspects that require careful clinical assessment. The anatomic extent of infection, the presumed pathogens involved and risk factors for antimicrobial resistance, the origin and extent of the infection, the patient\'s clinical condition, and the host\'s immune status should be assessed continuously to optimize the management of patients with complicated IAIs.
摘要:
腹内感染(IAIs)是全世界医院环境中发病率和死亡率的重要原因。IAI管理的基石包括快速,准确诊断;及时,充分的源头控制;适当的,根据药代动力学/药效学和抗菌药物管理原则进行短期抗菌治疗;以及用静脉输液和辅助血管加压药治疗危重病(败血症/器官功能障碍或纠正低血容量后的败血症性休克)的血流动力学和器官功能支持。在IAIs患者中,个性化方法对于优化结局至关重要,并且应基于需要仔细临床评估的多个方面.感染的解剖范围,涉及的假定病原体和抗菌药物耐药性的危险因素,感染的起源和程度,患者的临床状况,应持续评估宿主的免疫状态,以优化复杂IAIs患者的管理。