Complicated intra-abdominal infections: a focus on appendicitis and diverticulitis

Area of Science:

• Gastroenterology
• Infectious Diseases
• Surgical Infections

Background:

• Severe abdominal pain is a frequent medical complaint.
• Appendicitis and diverticulitis are common causes of complicated intra-abdominal infections, often stemming from obstructed pouches.
• These conditions represent over 80% of community-acquired complicated intra-abdominal infections.

Purpose of the Study:

• To compare the clinical presentations of appendicitis and diverticulitis.
• To review and contrast the treatment strategies for these two conditions.
• To highlight the importance of antimicrobial selection in managing complicated intra-abdominal infections.

Main Methods:

• Review of existing literature on appendicitis and diverticulitis.
• Comparison of diagnostic challenges and clinical manifestations.
• Analysis of current treatment guidelines, including antimicrobial regimens.

Main Results:

• Appendicitis and diverticulitis share similarities in pathophysiology (obstructed pouch leading to inflammation) but differ in presentation.
• Complicated intra-abdominal infections are typically polymicrobial, requiring broad-spectrum antimicrobial coverage.
• Standard regimens include piperacillin/tazobactam, imipenem/cilastatin, and fluoroquinolone-based therapies.

Conclusions:

• Appendicitis and diverticulitis necessitate prompt diagnosis and treatment.
• Effective management hinges on appropriate antimicrobial selection and duration to combat polymicrobial infections and prevent resistance.
• This review provides insights into the comparative aspects of these prevalent intra-abdominal infections.