Scientific evidence of the duration of antibiotic treatment in intra-abdominal infections with surgical focus control

Abstract

A non-systematic review of the published scientific evidence has been carried out on the duration of empirical antibiotic treatment in surgical intra-abdominal infections (IIA) with effective focus control. Given the progressive increase in antibiotic resistance, it is urgent to have strategies to reduce the pressure on the microbiota. The American guidelines made by Mazuski et al. of 2017¹, as the central axis in the recommendations of the duration of empirical antibiotic treatment in intra-abdominal infections with control of the focus and a bibliographic search of all the articles that contained the keywords in Pubmed and Google Scholar is added. 21 articles referring to the duration of empirical antibiotic treatment in intra-abdominal infection with control of the focus are collected. With the American guidelines and these articles, a proposal is prepared for the duration of empirical antibiotic treatment in patients without risk factors between 24 and 72 h. And in those who present risk factors, it should be individualized with active monitoring every 24 h of fever, paralytic ileus and leukocytosis (FIL), before an early detection of complications or the need for changes in antibiotic treatment. Short treatments are just as effective as those of longer durations and are associated with fewer adverse effects, therefore, daily adjusting and reassessing the duration of empirical antibiotic treatment is essential for better practice.

Keywords: Antibiotic therapy; Antibiotic treatment; Antibióticos profilácticos; Antimicrobial stewardship; Antimicrobial treatment’s length; Brief antibiotic prophylaxis and abdominal surgery; Duración del tratamiento antimicrobiano; Infección intraabdominal; Intra-abdominal infection; Intra-abdominal sepsis; Profilaxis antibiótica breve y cirugía abdominal; Programas de optimización uso de antibióticos; Prophylactic antibiotics; Sepsis intraabdominal; Terapia antibiótica; Tratamiento antibiótico.