[What should and should not be covered in intraabdominal infection]

Despite improvements in our knowledge of the physiopathology of severe infection, diagnostic methods, antibiotic therapy, postoperative care and surgical techniques, a substantial number of patients with intraabdominal infection (IAI) will develop advanced stages of septic insult requiring admission to the intensive care unit. The success of treatment of IAI is multifactorial and the best antibiotic protocol may be insufficient unless adequate control of the focus of infection has been achieved. The present article discusses the appropriacy of empirical antibiotic therapy and the main pathogens associated with treatment failure. We also analyze the patients at risk of infection with microorganisms requiring broad-spectrum antimicrobial coverage. However, excessive antibiotic treatment, in terms of either spectrum or duration, could jeopardize future patients in an environment already threatened by the scarcity of research and development into new molecules required for the emergence of pathogens resistant to current antibiotics.