Document Overview

Document Title

Diagnosis and Management of Complicated Intra-abdominal Infection in Adults and Children

Authoring Societies

Infectious Diseases Society of America

Surgical Infection Society

Document Publication Date

Jan 15, 2010

Page Last Reviewed/Updated

May 5, 2026

Document Type

Guideline

Country of Publication

United States

Full Text Freely Available

Yes

Full Text Guideline

academic.oup.com/cid/article/50/2/133/327316

Source Citation

Solomkin JS, Mazuski JE, Bradley JS, et al. Diagnosis and Management of Complicated Intra￾abdominal Infection in Adults and Children: Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis. 2010;50(2):133-64. Erratum in: Clin Infect Dis. 2010;50(12):1695. [PMID: 20034345]

Supplemental Implementation Resources

• Quick-Reference Guide
• Podcast

Document Scope, Criteria, and Use Cases

Document Objectives

The 2009 update of the guidelines contains evidence-based recommendations for the initial diagnosis and subsequent management of adult and pediatric patients with complicated and uncomplicated intra-abdominal infection. The multifaceted nature of these infections has led to collaboration and endorsement of these recommendations by the following organizations: American Society for Microbiology, American Society of Health-System Pharmacists, Pediatric Infectious Diseases Society, and Society of Infectious Diseases Pharmacists.

These guidelines make therapeutic recommendations on the basis of the severity of infection, which is defined for these guidelines as a composite of patient age, physiologic derangements, and background medical conditions. These values are captured by severity scoring systems, but for the individual patient, clinical judgment is at least as accurate as a numerical score. “High risk” is intended to describe patients with a range of reasons for increased rates of treatment failure in addition to a higher severity of infection, particularly patients with an anatomically unfavorable infection or a health care-associated infection.

Scope

Diagnosis, Management

Keywords

abdominal infections, appendicitis, cIAI, intra-abdominal infection

Target Patient Population

Adults and Children with Complicated Intra-abdominal Infection

Inclusion Criteria

Male, Female, Adolescent, Adult, Child, Older Adult

Health Care Settings

Ambulatory, Hospital, Operating and Recovery Room, Outpatient

Intended Users

Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

PICO Questions

1. What Are the Appropriate Procedures for Initial Evaluation of Patients with Suspected Intra-abdominal Infection?
2. When Should Fluid Resuscitation Be Started for Patients with Suspected Intra-abdominal Infection?
3. When Should Antimicrobial Therapy Be Initiated for Patients with Suspected or Confirmed Intra-abdominal Infection?
4. What Are the Proper Procedures for Obtaining Adequate Source Control?
5. When and How Should Microbiological Specimens Be Obtained and Processed?
6. What Are Appropriate Antimicrobial Regimens for Patients with Community-Acquired Intra-abdominal Infection of Mild-to-Moderate Severity?
7. What Are Appropriate Antimicrobial Regimens for Patients with Community-Acquired Intra-abdominal Infection of High Severity?
8. What Antimicrobial Regimens Should Be Used in Patients with Health Care-Associated Intra-abdominal Infection, Particularly with Regard to Candida, Enterococcus, and MRSA?
9. What Are Appropriate Diagnostic and Antimicrobial Therapeutic Strategies for Acute Cholecystitis and Cholangitis?
10. What Are Appropriate Antimicrobial Regimens for Pediatric Patients with Community-Acquired Intra-abdominal Infection?
11. What Constitutes Appropriate Antibiotic Dosing?
12. How Should Microbiological Culture Results Be Used to Adjust Antimicrobial Therapy?
13. What Is the Appropriate Duration of Therapy for Patients with Complicated Intra-abdominal Infection?
14. What Patients Should Be Considered for Oral or Out-patient Antimicrobial Therapy and What Regimens Should Be Used?
15. How Should Suspected Treatment Failure Be Managed?
16. What Are the Key Elements that Should Be Considered in Developing a Local Appendicitis Pathway?

Number of Source Documents

189

Literature Search End Date

Monday, December 1, 2008

Includes peer/external review process?

Yes

Includes public comment process?

No

Methodologist involvement?

Yes

Patient involvement?

No

Includes multi-disciplinary group?

Yes

Includes systematic review?

Yes

Grades quality of strength of evidence?

Yes

Grades quality of strength of recommendation?

Yes

Discloses conflicts of interest?

Yes

Includes benefits/harms analysis with recommendations?

No