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Current advances in pharmacotherapeutic strategies for the treatment of complicated intra-abdominal infections
Philippe Montravers1,2,3, Enora Atchade1, Nathalie Zappella1
1Department of Anaesthesiology and Surgical Intensive Care, DMU PARABOL, APHP, Hôpital Bichat, Paris, France.
Expert Opinion on Pharmacotherapy
|June 25, 2026
Summary
This review examines anti-infective therapy for complicated intra-abdominal infections (cIAIs). It highlights challenges like multidrug resistance and pharmacokinetic issues, emphasizing personalized dosing and global surveillance for better outcomes.
Area of Science:
- Infectious Diseases
- Pharmacology
- Surgical Emergencies
Background:
- Complicated intra-abdominal infections (cIAIs) are significant causes of surgical emergencies.
- These infections are often polymicrobial, involving bacteria and fungi, complicated by rising antimicrobial resistance.
Purpose of the Study:
- To explore strategies for effective anti-infective therapy in cIAIs.
- To review current literature on managing cIAIs, focusing on therapeutic approaches.
Main Methods:
- Literature review of PubMed and SMART databases up to March 2026.
- Analysis of strategies for implementing anti-infective therapy in cIAIs.
Main Results:
- Multidrug-resistant Gram-negative and Gram-positive organisms present major challenges.
- Pharmacokinetic variability necessitates personalized dosing strategies, and the role of antifungals requires further clarification.
Conclusions:
- Advances in diagnostics and novel agents improve outcomes, but gaps remain.
- Refining pharmacokinetic modeling, expanding therapeutic drug monitoring, and global resistance surveillance are crucial for optimal cIAI management.
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