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Current strategies for the treatment of complicated intraabdominal infections

机译：当前治疗复杂腹腔感染的策略

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Introduction: Complicated intraabdominal infections (cIAIs) are a common cause of infection-related morbidity and mortality in hospitalized patients and present many challenges unique from other serious infections. cIAIs are generally polymicrobial in nature; however, controversy exists around the pathogenicity of some of the frequently identified microorganisms. Increasing antibiotic resistance among commonly isolated bacteria poses further challenges for clinicians managing patients with cIAIs. Areas covered: This article highlights the microbiology and recent trends in antibiotic resistance most relevant to cIAIs, provides recommendations for treatment using currently available antimicrobials and introduces antibiotics in development with potential roles in managing cIAIs. Expert opinion: Successful treatment of cIAI requires a combination of timely source control and thorough assessment of patient characteristics to guide selection of an appropriate empiric antimicrobial regimen. Specific considerations that should be made when choosing antibiotics include the origin of infection, presence of risk factors for potentially resistant pathogens and severity of disease. While it is encouraging that agents in development may prove helpful in the treatment of cIAIs with resistant pathogens, further identification of novel antibiotics is needed to address this growing concern. In addition, adherence to the principles of antimicrobial stewardship is needed if current antimicrobial resources are to be preserved for the treatment of cIAIs.
机译：简介：复杂的腹腔内感染（cIAI）是住院患者感染相关的发病率和死亡率的常见原因，并带来了许多其他严重感染所特有的挑战。 cIAI通常本质上是多微生物的;然而，围绕一些常见微生物的致病性存在争议。对于处理cIAIs的临床医生来说，通常分离出的细菌中抗生素耐药性的提高提出了进一步的挑战。涵盖的领域：本文重点介绍了与cIAI最相关的微生物学和抗生素耐药性的最新趋势，为使用当前可用的抗菌剂的治疗提供了建议，并介绍了正在开发中的抗生素，这些抗生素在管理cIAIs中可能发挥作用。专家意见：cIAI的成功治疗需要结合及时的源控制和患者特征的全面评估，以指导选择适当的经验性抗菌方案。选择抗生素时应特别考虑的因素包括感染的起源，潜在耐药病原体的危险因素和疾病的严重性。尽管令人鼓舞的是，开发中的药物可证明对具有耐药病原体的cIAI的治疗有帮助，但仍需要进一步鉴定新型抗生素来解决这一日益严重的问题。此外，如果要保留现有的抗菌素资源用于治疗cIAI，则需要遵守抗菌素管理原则。

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