Intra-abdominal infections (IAIs) are an important cause of morbidity and mortality in hospital settings worldwide. The cornerstones of IAI management include rapid, accurate diagnostics; timely, adequate source control; appropriate, short-duration antimicrobial therapy administered according to the principles of pharmacokinetics/pharmacodynamics and antimicrobial stewardship; and hemodynamic and organ functional support with intravenous fluid and adjunctive vasopressor agents for critical illness (sepsis/organ dysfunction or septic shock after correction of hypovolemia). In patients with IAIs, a personalized approach is crucial to optimize outcomes and should be based on multiple aspects that require careful clinical assessment. The anatomic extent of infection, the presumed pathogens involved and risk factors for antimicrobial resistance, the origin and extent of the infection, the patient's clinical condition, and the host's immune status should be assessed continuously to optimize the management of patients with complicated IAIs.

• Keywords
• Antimicrobial resistance, Antimicrobial therapy, Intra-abdominal infections, Source control,
• MeSH
• Anti-Bacterial Agents therapeutic use   MeSH
• Humans MeSH
• Intraabdominal Infections * drug therapy   MeSH
• Risk Factors MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Names of Substances
• Anti-Bacterial Agents MeSH

Antimicrobial susceptibility of clinical isolates collected from sites in central Europe in 2019 was tested by CLSI broth microdilution method and EUCAST breakpoints. Most active were amikacin, ceftazidime-avibactam and colistin; respectively, susceptibility rates among P. aeruginosa (n = 701) were 89.2%, 92.2% and 99.9%; difficult-to-treat (DTR) isolates, 62.5%, 37.5% and 100%; multidrug-resistant (MDR) isolates, 68.3%, 72.9% and 99.5%; meropenem-resistant (MEM-R), metallo-β-lactamase-negative (MBL-negative) isolates, 72.8%, 78.6% and 100%. Among Enterobacterales (n = 1639), susceptibility to ceftazidime-avibactam, colistin and tigecycline was ≥ 97.9%; MDR Enterobacterales, 96.8%, 94.4% and 100%, respectively; DTR isolates, ≥ 76.2% to ceftazidime-avibactam and colistin; MEM-R, MBL-negative isolates, ≥ 90.0% to ceftazidime-avibactam and colistin.

• Keywords
• ATLAS, Antimicrobial surveillance, Ceftazidime-avibactam, Difficult-to-treat, Enterobacterales, Pseudomonas aeruginosa,
• MeSH
• Anti-Bacterial Agents pharmacology   therapeutic use   MeSH
• Azabicyclo Compounds MeSH
• Ceftazidime pharmacology   MeSH
• Enterobacteriaceae MeSH
• Drug Combinations MeSH
• Colistin * pharmacology   MeSH
• Humans MeSH
• Meropenem MeSH
• Microbial Sensitivity Tests MeSH
• Pseudomonas aeruginosa * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH
• Croatia MeSH
• Lithuania MeSH
• Latvia MeSH
• Hungary MeSH
• Poland MeSH
• Names of Substances
• Anti-Bacterial Agents MeSH
• avibactam, ceftazidime drug combination MeSH Browser
• Azabicyclo Compounds MeSH
• Ceftazidime MeSH
• Drug Combinations MeSH
• Colistin * MeSH
• Meropenem MeSH

This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings.

• Keywords
• Antibiotics, Intra-abdominal infections, Peritonitis, Sepsis,
• MeSH
• Anti-Bacterial Agents therapeutic use   MeSH
• Appendectomy methods   MeSH
• Abdominal Pain etiology   MeSH
• Cholecystectomy, Laparoscopic methods   MeSH
• Diverticulitis surgery   MeSH
• Laparoscopy methods   statistics & numerical data   MeSH
• Humans MeSH
• Decision Support Techniques MeSH
• Intra-Abdominal Hypertension etiology   prevention & control   MeSH
• Intraabdominal Infections complications   surgery   MeSH
• Tomography, X-Ray Computed methods   MeSH
• Guidelines as Topic * MeSH
• Ultrasonography methods   MeSH
• Organ Dysfunction Scores MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Consensus Development Conference MeSH
• Review MeSH
• Names of Substances
• Anti-Bacterial Agents MeSH

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.

• MeSH
• Drug Resistance, Microbial MeSH
• Anti-Infective Agents pharmacology   MeSH
• Humans MeSH
• International Cooperation * MeSH
• Microbial Sensitivity Tests MeSH
• Intraabdominal Infections * diagnosis   drug therapy   microbiology   MeSH
• Prognosis MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Names of Substances
• Anti-Infective Agents MeSH