The Surgical Infection Society Guidelines on the Management of Intra-Abdominal Infection: 2024 Update

Area of Science:

• Infectious Diseases
• Surgical Infections
• Evidence-Based Medicine

Background:

• The Surgical Infection Society (SIS) has periodically updated evidence-based guidelines for intra-abdominal infection (IAI) management since 1992.
• Previous guidelines were published in 2002, 2010, and 2017.
• This document presents the most recent guideline update.

Purpose of the Study:

• To provide an updated, evidence-based guideline for the prevention and management of intra-abdominal infections (IAI) in adult patients.
• To incorporate recent literature findings into clinical practice recommendations.
• To guide antimicrobial selection, timing, duration, source control, and stewardship.

Main Methods:

• A systematic literature review was conducted using major databases (PubMed/Medline, Cochrane Library, Embase, Web of Science) from 2016 to February 2024.
• The review focused on randomized controlled trials, systematic reviews, and meta-analyses concerning adult intra-abdominal infections.
• The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system was used to rate evidence quality and recommendation strength.

Main Results:

• The guideline includes new and updated recommendations for IAI management.
• Recommendations cover antimicrobial therapy (selection, timing, duration, de-escalation), source control, specific pathogens, disease processes, and antimicrobial stewardship.
• Evidence quality was rated high (A), moderate (B), or weak (C), with recommendations rated strong (1) or weak (2).

Conclusions:

• This updated guideline provides the most current, evidence-based recommendations from the SIS for adult IAI prevention and management.
• It aims to optimize patient outcomes through informed clinical decision-making.
• Implementation of antimicrobial stewardship programs is a key component.