复杂性腹腔感染及喹诺酮类抗菌药物的地位.ppt

Slide Objective: To review the overall antimicrobial management according to the 2003 IDSA Guidelines for cIAI. Speaker Notes: According to the 2003 IDSA Guidelines for cIAI: Fluid resuscitation is generally required prior to initiating antibiotic to restore adequate visceral perfusion and ensure drug distribution. Once intra-abdominal infection is suspected, empirical antimicrobial therapy must be initiated. Antimicrobial therapy can be discontinued in patients when they have no clinical evidence of infection such as fever or leukocytosis. If clinical evidence of infection persists at the end of the time period designated for antimicrobial therapy, appropriate diagnostic investigations should be undertaken, rather than prolongation of antimicrobial treatment. If adequate source control cannot be achieved, diagnostic investigation with ultrasound or CT scan is warranted. Ensure that the current antimicrobial is effective against the infecting organisms. Additional surgical intervention may be required for source control. Reference: Solomkin et al. IDSA Guidelines. Clin Infect Dis. 2003 Oct 15;37(8):997-1005 Slide Objective: To present the antimicrobial regimens for the treatment of intra-abdominal infections recommended by the 2003 IDSA Guidelines for mild, moderate, and high-severity cIAIs. Speaker Notes: The antimicrobials listed in the slide are considered appropriate therapy for the treatment of intra-abdominal infections. No regimen has been consistently demonstrated to be superior or inferior. Patients with more-severe infections, as defined by accepted physiologic scoring systems, or patients deemed to have immunosuppression subsequent to medical therapy or acute or chronic disease, might benefit from regimens with broader spectrum in vitro activity against facultative and aerobic gram-negative organisms as listed on the slide. Nosocomial infections are caused by more-resistant flora; for these infections, complex multi-drug regimens are recommended,