Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.

1st Department of Surgery Department of Abdominal Thoracic Surgery and Traumatology 1st Faculty of Medicine Charles University and General University Hospital Prague Czech Republic

1st Department of Surgery Tzaneion General Hospital Piraeus Greece

2nd Department of Surgery Aretaieion University Hospital National and Kapodistrian University of Athens Athens Greece

2nd Surgical Clinic Emergency Hospital of Craiova Craiova Romania

3rd Department of Surgery Attiko Hospital MSc Global Health Disaster Medicine National and Kapodistrian University of Athens Athens Greece

Abdominal Center Helsinki University Hospital and University of Helsinki Helsinki Finland

Anesthesia and Transplant Surgical Intensive Care Unit Ospedali Riuniti Ancona Italy

Clinical Department of Medical Surgical and Health sciences Trieste University Trieste Italy

Department General Surgery Kipshidze Central University Hospital Tbilisi Georgia

Department of Abdominal Surgery Vladimir City Clinical Hospital of Emergency Medicine Vladimir Russia

Department of Aeromedical Services for Emergency and Trauma Care Ehime University Graduate School of Medicine Ehime Japan

Department of Anesthesiology Neuro Intensive Care Unit Florence Careggi University Hospital Florence Italy

Department of Clinical and Experimental Sciences University of Brescia Brescia Italy

Department of Emergency medicine Anesthesiology and critical care Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Department of Emergency Surgery City Hospital Mozyr Belarus

Department of Emergency Surgery Parma Maggiore Hospital Parma Italy

Department of General and Emergency Surgery ASMN Reggio Emilia Italy

Department of General and Emergency Surgery Cagliari University Hospital Cagliari Italy

Department of General and Emergency Surgery Faculty of Medicine Mansoura University Hospital Mansoura Egypt

Department of General and Thoracic Surgery University Hospital Giessen Giessen Germany

Department of general Digestive and Metabolic Minimally Invasive Surgery Centre Hospitalier Intercommunal De Poissy St Germain en Laye Poissy France

Department of General Emergency and Trauma Surgery Pisa University Hospital Pisa Italy

Department of general surgery Bizerte hospital Faculty of Medicine of Tunis University Tunis El Manar Tunis Tunisia

Department of General Surgery Health Sciences University Samsun Training and Research Hospital Samsun Turkey

Department of General Surgery Kasturba Medical College and Hospital Manipal Academy of Higher Education Manipal India

Department of General Surgery Mansoura Faculty of Medicine Mansoura University Mansoura Egypt

Department of General Surgery Medical University of Plovdiv UMHAT Eurohospital Plovdiv Bulgaria

Department of General Surgery Rambam Health Care Campus Haifa Israel

Department of General Surgery School of Medicine Istanbul Medeniyet University Istanbul Turkey

Department of General Surgery Tan Tock Seng Hospital Singapore Singapore

Department of General Surgery University Hospital of Coventry and Warwickshire Coventry UK

Department of General Surgery University of Insubria University Hospital of Varese ASST Sette Laghi Regione Lombardia Varese Italy

Department of Infectious Diseases Bolzano Hospital Bolzano Italy

Department of Medical and Surgical Sciences Emergency Surgery and Trauma Fondazione Policlinico Universitario A Gemelli IRCCS Rome Italy

Department of Medicine Infectious Disease Division King Fahad Medical City Riyadh Saudi Arabia

Department of Molecular and Translational Medicine University of Brescia Brescia Italy

Department of Pharmacy Lebanese International University Beirut Lebanon

Department of Pharmacy Practice National Institute of Pharmaceutical Education and Research Hajipur Bihar India

Department of Surgery 2 National Medical University Kharkiv Ukraine

Department of Surgery AAST Cremona Cremona Italy

Department of Surgery Amsterdam University Medical Centers location AMC Amsterdam Gastroenterology Endocrinology Metabolism Research Institute Amsterdam The Netherlands

Department of Surgery Anadolu Medical Center Kocaeli Turkey

Department of Surgery Camerino Hospital Macerata Italy

Department of Surgery Clinical Center University of Pecs Pecs Hungary

Department of Surgery College of Medicine and Health Sciences UAE University Al Ain United Arab Emirates

Department of Surgery Department of Surgery Macerata Hospital Macerata Italy

Department of Surgery Division of Acute Care Surgery and Center for Sepsis and Critical Illness Research University of Florida College of Medicine Gainesville FL USA

Department of Surgery Edendale Hospital Pietermaritzburg South Africa

Department of Surgery Emergency Hospital of Bucharest Bucharest Romania

Department of Surgery Faculty of Clinical Sciences College of Health Sciences Obafemi Awolowo University Osun State Ile Ife Nigeria

Department of Surgery Fondazione IRCCS Policlinico San Matteo University of Pavia Pavia Italy

Department of Surgery Hassan 2 University Hospital Medical School of Fez Sidi Mohamed Benabdellah University Fez Morocco

Department of Surgery Hospital Universitário Terezinha de Jesus Faculdade de Ciências Médicas e da Saúde de Juiz de Fora Juiz de Fora Brazil

Department of Surgery Ilsan Paik Hospital Inje University College of Medicine Goyang Republic of Korea

Department of Surgery Jacobi Medical Center Albert Einstein College of Medicine Bronx NY USA

Department of Surgery Lumbini Medical College and Teaching Hospital Ltd Palpa Tansen Nepal

Department of Surgery Post Graduate Institute of Medical Sciences Rohtak India

Department of Surgery Royal Infirmary of Edinburgh Edinburgh UK

Department of Surgery St Josef Hospital Ruhr University Bochum Bochum Germany

Department of Surgery Texas Health Resources Fort Worth TX USA

Department of Surgery Tianjin Nankai Hospital Nankai Clinical School of Medicine Tianjin Medical University Tianjin China

Department of Surgery UMC Ljubljana Ljubljana Slovenia

Department of Surgery Universidad del Valle Cali Colombia

Department of Surgery Universidad Nacional de Asuncion Asuncion Paraguay

Department of Surgery Università Politecnica delle Marche Ancona Italy

Department of Surgery University Clinical Center of Tuzla Tuzla Bosnia and Herzegovina

Department of Surgery University Hospital Centre Zagreb Zagreb Croatia

Department of Surgery University Hospital of Trauma Tirana Albania

Department of Surgery University of Ilorin Teaching Hospital Ilorin Nigeria

Department of Surgery University of Pittsburgh School of Medicine UPMC Presbyterian Pittsburgh USA

Department of Surgery University of Washington Seattle WA USA

Department of Surgery Virginia Commonwealth University School of Medicine Richmond VA USA

Department of Surgery Western Michigan University School of Medicine Kalamazoo MI USA

Department of Surgical Disciplines Immanuel Kant Baltic Federal University Regional Clinical Hospital Kaliningrad Russia

Department of Upper GI Surgery Queen Elizabeth Hospital University Hospitals Birmingham NHS Foundation Trust Birmingham UK

Division of Trauma Acute Care Surgery Scripps Clinic Medical Group La Jolla CA USA

Division of Trauma and Acute Care Surgery Department of Surgery University of California Davis Sacramento CA USA

Division of Trauma and Acute Care Surgery Fundacion Valle del Lili Cali Colombia

Division of Trauma and Surgical Critical Care Department of Surgery University of Southern California Los Angeles CA USA

Donegal Clinical Research Academy Emergency Surgery Outcome Project Letterkenny University Hospital Donegal Ireland

Emergency and General Surgery Department University of Milan Bicocca Milan Italy

Emergency Department Niguarda Ca'Granda Hospital Milan Italy

Emergency Surgery Unit San Filippo Neri's Hospital Rome Italy

Ernest E Moore Shock Trauma Center at Denver Health Denver USA

General Acute Care Abdominal Wall Reconstruction and Trauma Surgery Foothills Medical Centre Calgary AB Canada

General Direction Area Vasta 3 ASUR Marche Macerata Italy

General Surgery Department Colorectal Surgery Unit La Paz University Hospital Madrid Spain

General Surgery Department Military Teaching Hospital Dakar Senegal

General Surgery Department Regional Hospital of Durres Durres Albania

General Surgery Unit Sansepolcro Hospital Arezzo Italy

Global Alliance for Infections in Surgery Macerata Italy

Infection Control Hospital de Base Brasília DF Brazil

Minimally Invasive and Robotic Digestive Surgery Unit Regional General Hospital F Miulli Bari Italy

National Institute for Infectious Diseases INMI Lazzaro Spallanzani IRCCS Rome Italy

Riverside University Health System CECORC Research Center Loma Linda University Loma Linda USA

School of Medical Sciences Universitiy Sains Malaysia Kota Bharu Kelantan Malaysia

Surgery Department Tbilisi State Medical University Tbilisi Georgia

Surgical Clinic Nikola Spasic Faculty of Medicine University of Belgrade Belgrade Serbia

Trauma and Acute Care Surgery Unit Hadassah Hebrew University Medical Center Jerusalem Israel

Trauma Service Inkosi Albert Luthuli Central Hospital and Department of Surgery Nelson R Mandela School of Clinical Medicine Durban South Africa

Université Paris Est UPEC Creteil France

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