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• W2117230718 abstract "IAIs remain a major challenge in clinical practice. They are the main cause of postoperative morbidity following abdominal surgery and the most frequent cause for admission to a surgical intensive care unit (2,3). IAIs differ from infections encountered elsewhere in several respects. First, the clinical spectrum of IAI is extremely wide, ranging from uncomplicated acute appendicitis with a relatively benign course to diffuse peritonitis from perforated viscus or ischemic bowel with high morbidity and mortality. While both scenarios comprise of IAIs, they require different approaches to diagnosis and treatment. Additionally, the role of surgery in the management of patients with IAIs is pivotal and generally considered to be a decisive factor in the outcome. The clinical and microbiological diagnosis is also often problematic: IAIs are typically polymicrobial, and not every microorganism involved can be identified in the clinical microbiology laboratory by routine cultures; the pathogenicity of certain microorganisms cultured from IAIs is not considered to be the same for every patient and often relates more directly to the severity of underlying disease or comorbid conditions of the host; and the clinical signs and symptoms do not often match the severity of disease and may lead to substantial delays in appropriate diagnosis and management (3–8). Additionally, antibiotic resistance among enteric pathogens has evolved globally and at an alarming rate, while very few newer agents have emerged to replace older therapeutic regimens.The current clinical practice guideline was jointly developed by the CSS and AMMI Canada. The primary goal was to develop updated recommendations for the medical and surgical management of complicated IAIs since publication of the 2003 antimicrobial treatment guideline by the IDSA (1). Particular focus is directed at risk stratification for poor outcomes based on epidemiological studies, current status of antimicrobial susceptibility and resistance profiles among enteric pathogens, therapeutic efficacy of antimicrobial regimens based on randomized clinical trials, operative versus percutaneous approaches for source control, the role of IAH and ACS in IAIs, and infection control and preventive measures for postoperative IAIs and surgical site infections. An additional objective is to categorize the recommendations according to the strength and quality of the available evidence using a standardized grading system. Importantly, the current guideline provides recommendations for initial empirical antimicrobial management of complicated IAIs based on clinical settings and issues unique to the Canadian health care system (eg, publicly funded health care system and regionalization of health care delivery)." @default.
• W2117230718 created "2016-06-24" @default.
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• W2117230718 date "2010-01-01" @default.
• W2117230718 modified "2023-10-18" @default.
• W2117230718 title "Canadian Practice Guidelines for Surgical Intra-Abdominal Infections" @default.
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