Updated Guidelines Are Released for Management of Intra-Abdominal Infections

Huston JM, Barie PS, Dellinger EP, et al. The Surgical Infection Society Guidelines on the Management of Intra-Abdominal Infection: 2024 Update. Surg Infect. In press 2024.

Guidelines for management of complicated intra-abdominal infections (IAI)—infections involving the peritoneum, retroperitoneum, abdominal wall, and/or multiple abdominal organs—have been produced and regularly updated by the Surgical Infection Society since 1992. This latest update provided clear recommendations for antimicrobial management of this condition based on patient risk assessment and the potential for infection caused by multidrug resistant organisms.

High-risk patients can be defined by using available scoring systems (APACHE score), presence of sepsis or septic shock, delayed or inadequate source control, healthcare-related IAI, diffuse peritonitis, and comorbid conditions (advanced age, malignancy, cardiovascular disease, hepatic dysfunction, and kidney failure).

A detailed discussion of risk assessment was presented in the 2017 update of the guidelines; the 2024 update and the 2017 document are available on the Surgical Infection Society website.

The current update provided clear recommendations for choosing antimicrobial therapy for various types of IAI, as well as for prophylaxis for patients being treated for conditions such as appendicitis and abdominal trauma. In addition, recommendations for timing of source control procedures are presented. Source control is recommended within 12 hours of diagnosis in low-risk patients and within six hours for high-risk patients.

The updated guidelines are detailed and well organized. Surgeons are encouraged to review the entire document.