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Surgical Infection Society Guidelines on the Prevention and Management of Pediatric Intra-Abdominal Infection: 2025
Jared M Huston1,2, Joseph D Forrester3, Philip S Barie4
1Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, New Hyde Park, New York, USA.
Insights
Updated guidelines offer evidence-based recommendations for preventing and managing pediatric intra-abdominal infections (IAI). These guidelines cover antimicrobial selection, treatment protocols, and infection control strategies for children.
Area of Science:
- Pediatric Infectious Diseases
- Surgical Infections
- Evidence-Based Medicine
Background:
- The Surgical Infection Society (SIS) previously published guidelines for pediatric intra-abdominal infection (IAI).
- Current literature necessitates an update to these evidence-based guidelines.
- This document presents revised recommendations based on a recent systematic review.
Purpose of the Study:
- To provide updated, evidence-based guidelines for the prevention and management of pediatric intra-abdominal infections (IAI).
- To synthesize current literature and expert consensus into actionable clinical recommendations.
- To inform best practices for healthcare professionals treating children with IAI.
Main Methods:
- A systematic literature review was conducted across major databases (PubMed, Cochrane Library, Embase, Web of Science) from January 2016 to October 2024.
- The review focused on randomized controlled trials, systematic reviews, and meta-analyses concerning pediatric intra-abdominal infections.
- Recommendations were developed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system and finalized through an iterative review and voting process.
Main Results:
- The updated SIS guideline provides comprehensive, evidence-based recommendations for pediatric IAI.
- Key areas addressed include preferred antimicrobial agents, administration timing and routes, and therapy duration.
- Guidance also covers specific pathogen treatment, disease process management, infection control, and antimicrobial stewardship.
Conclusions:
- These updated guidelines represent the most current recommendations for preventing and treating intra-abdominal infections in pediatric patients.
- The guidelines aim to improve patient outcomes through standardized, evidence-based care.
- Implementation of these recommendations is crucial for optimizing pediatric IAI management.
Background:
The Surgical Infection Society (SIS) published evidence-based guidelines for prevention and management of pediatric intra-abdominal infection (IAI). Here we present updated guidelines on the basis of a systematic review of current literature.
Methods:
The writing group included members of SIS' Therapeutics and Guidelines Committee, other SIS members with content or guideline expertise, and a professional medical librarian. A systematic literature review using PubMed®/MEDLINE, the Cochrane Library, Embase, and Web of ScienceTM was performed from January 2016 to October 2024. Keyword descriptors combined "surgical site infections" or "intra-abdominal infections" in pediatric patients limited to randomized controlled trials, systematic reviews, or meta-analyses. Additional relevant publications identified during literature review were included. Publications were evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. The strength of each recommendation was rated strong (1) or weak (2). Quality of the evidence was rated high (A), moderate (B), or weak (C). Final recommendations were developed by an iterative review process. All writing group members voted to accept each recommendation included in the final article.
Results:
This updated SIS guideline contains evidence-based recommendations for prevention and management of IAI in children. Recommendations include selection of preferred antimicrobial agents; timing and route of administration; duration of therapy; treatment of specific pathogens; treatment of specific intra-abdominal disease processes; implementation of hospital-based infection control and prevention tactics; and implementation of hospital-based antimicrobial stewardship programs.
Summary:
Herein are the most current recommendations for prevention and treatment of IAI in pediatric patients.
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