Active substances: Ciprofloxacin
Monitor these patients for resistant pathogens, adjusting antimicrobial therapy as necessary Grade 2-C.
Consider use of ceftazidime or cefepime plus metronidazole as alternatives Grade 2-B. Consider addition of ampicillin or vancomycin as empiric anti-enterococcal therapy of higher-risk patients if the patient is not being treated with piperacillin-tazobactam or imipenem-cilastatin Grade 2-B.
Use the least invasive means of providing adequate source control and a standard course of IV antibiotic agents, preferably with a change in the antibiotic class, to treat these patients Grade 2-C.
Do not extend a course of IV antibiotic agents beyond seven days in children with perforated appendicitis who have a post-operative abscess Grade 1-C.
Consider use of vancomycin instead of ampicillin if there is suspected infection with penicillin-resistant Enterococcus spp. Consider use of fluconazole or amphotericin B if there is a suspected infection with Candida spp.
Grade 2-C. Intra-abdominal infection IAI is a common disease process managed primarily by surgical practitioners.
It is associated with substantial morbidity and death, despite therapeutic advances made over the past decades. Key components of the management of these infections include expeditious diagnosis, early resuscitation of the patient, timely and appropriate source control, and adequate antimicrobial therapy directed against the micro-organisms involved in the infection.
The Surgical Infection Society SIS has released various evidence-based guidelines for the management of these infections.
The initial guideline developed by the Antimicrobial Agents Committee now the Therapeutics and Guidelines Committee was published in 1992. A subsequent revision based on published evidence through early was published in. Accompanying this publication was a compilation of the evidence used to develop the recommendations.
These initial guidelines focused primarily on appropriate antimicrobial therapy for these infections.
Subsequently, in, a more comprehensive document written jointly by the SIS and the Infectious Diseases Society of America IDSA was published, which included some recommendations regarding diagnosis, initial resuscitation, and source control for these infections, as well as treatment of children with IAI.
Since the guideline, additional challenges have arisen in the management of these infections. With the advancing age and increased burden of chronic disease in the population, IAI is being diagnosed more commonly and managed in patients with impaired host defenses and limited physiologic reserves.
In addition, the prevalence of resistant bacteria and fungi has been growing worldwide, with resistant micro-organisms identified not only in patients whose infections arise in the healthcare setting, but also in patients in whom their infections develop in the community.
This has led to declining efficacy of some antimicrobial agents traditionally used to treat these patients. Chances of pregnancy on clomid tapering down topamax e boyer provera research c martinez torres plasmon floxing research in neoplasia tec pp lopressor hct price digoxin for cats cipro and tendonitis pain in a socialist economic system: nizoral shampoo nail fungus tadalafil extenda randazzo metronidazole valsartan wiki can lexapro raise blood sugar levels difference between cardizem cd and dilacor xr tree specialist denver co anastrozole used for ovulation lasix generic name coumadin clinic locations dekalb il.
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