Abstract:
Background: The Surgical Infection Society (SIS) published evidence-based guidelines for the management of intra-abdominal infection (IAI) in 1992, 2002, 2010, and 2017. Here, we present the most recent guideline update based on a systematic review of current literature. Methods: The writing group, including current and former members of the SIS Therapeutics and Guidelines Committee and other individuals with content or guideline expertise within the SIS, working with a professional librarian, performed a systematic review using PubMed/Medline, the Cochrane Library, Embase, and Web of Science from 2016 until February 2024. Keyword descriptors combined \"surgical site infections\" or \"intra-abdominal infections\" in adults limited to randomized controlled trials, systematic reviews, and meta-analyses. Additional relevant publications not in the initial search but identified during literature review were included. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system was utilized to evaluate the evidence. The strength of each recommendation was rated strong (1) or weak (2). The quality of the evidence was rated high (A), moderate (B), or weak (C). The guideline contains new recommendations and updates to recommendations from previous IAI guideline versions. Final recommendations were developed by an iterative process. All writing group members voted to accept or reject each recommendation. Results: This updated evidence-based guideline contains recommendations from the SIS for the treatment of adult patients with IAI. Evidence-based recommendations were developed for antimicrobial agent selection, timing, route of administration, duration, and de-escalation; timing of source control; treatment of specific pathogens; treatment of specific intra-abdominal disease processes; and implementation of hospital-based antimicrobial agent stewardship programs. Summary: This document contains the most up-to-date recommendations from the SIS on the prevention and management of IAI in adult patients.
摘要:
背景:外科感染学会(SIS)于1992年,2002年,2010年和2017年发布了基于证据的腹腔内感染管理指南(IAI)。这里,我们基于对现有文献的系统回顾,提出了最新的指南更新.方法:写作小组,包括SIS治疗和指南委员会的现任和前任成员以及SIS中具有内容或指南专业知识的其他个人,与专业图书馆员合作,使用PubMed/Medline进行了系统评价,Cochrane图书馆,Embase,和WebofScience从2016年到2024年2月。关键词描述符结合“手术部位感染”或“腹内感染”在成人中仅限于随机对照试验,系统评价,和荟萃分析。包括初始搜索中没有但在文献综述中发现的其他相关出版物。建议的分级,评估,发展,和评估(等级)系统用于评估证据。每个建议的强度被评为强(1)或弱(2)。证据质量被评为高(A),中度(B),或者弱(C)。该指南包含新的建议和对以前IAI指南版本的建议的更新。最后建议是通过迭代过程制定的。所有写作小组成员投票接受或拒绝每个建议。结果:此更新的循证指南包含SIS对IAI成年患者治疗的建议。为抗菌药物选择制定了循证建议,定时,给药途径,持续时间,和降级;源头控制的时机;特定病原体的治疗;特定腹腔内疾病过程的治疗;以及基于医院的抗菌药物管理计划的实施。摘要:本文件包含SIS关于成人患者IAI预防和管理的最新建议。