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IDSA Releases New Guidelines for Complicated Intra-Abdominal Infections 

Recommendations help clinicians with clinical assessment and diagnosis

The Infectious Diseases Society of America has released new guidelines on complicated intra-abdominal infections in children, adults and pregnant people. These infections are associated with significant morbidity and mortality (sepsis and septic shock), especially if untreated. Appropriate management —including appropriate radiological diagnostics, careful use of the clinical microbiology laboratory and the correct selection of empiric therapy that is consistent with the principles of antibiotic stewardship — can have a significant impact on outcomes.  

The current guidelines provide recommendations for assessing risk, use of diagnostic imaging, and microbiological evaluation of complex acute conditions such as appendicitis, cholecystitis, cholangitis, diverticulitis, abdominal abscess and secondary bowel perforation.

“Complicated intra-abdominal infections are common and life-threatening,” said Robert A. Bonomo, MD, FIDSA, professor of medicine at Case Western Reserve University and lead author of the guidelines. “These new guidelines will help hospitalists, intensive care clinicians and specialists in infectious diseases, surgery and emergency care make better informed recommendations for patients, backed by the most current science and research available.”

The guidelines include recommendations for use of CT, ultrasound or MRI for different infections based on patient population and appropriate use of blood or intra-abdominal cultures to inform antimicrobial therapy. 

The new recommendations are the first in a series of updates to IDSA’s 2010 guidelines on these infections and the first released under IDSA’s new publication model. The new model allows individual components of a guideline to be updated and released before the complete guideline is published, providing front-line clinicians with the latest and most relevant clinical recommendations sooner. Under this new model, completed guidelines will be published in IDSA’s Clinical Infectious Diseases journal in a new biannual Guidelines Supplement.

In addition to Dr. Bonomo, guideline authors include Anthony W. Chow, MD, FIDSA; Morven S. Edwards, MD, FIDSA; Romney Humphries, PhD, FIDSA; Pranita D. Tamma, MD; Fredrick M. Abrahamian, DO, FIDSA; Mary Bessesen, MD; E. Patchen Dellinger, MD, FIDSA; Ellie Goldstein, MD, FIDSA; Mary K. Hayden, MD, FIDSA; Keith Kaye, MD, FIDSA; Brian A. Potoski, PharmD; Jesús Rodríguez Baño, MD, PhD; Robert Sawyer, MD, FIDSA; Marion Skalweit, MD; David R. Snydman, MD, FIDSA; Sarah Pahlke, MS; Katelyn Donnelly, MPH; and Jennifer Loveless, MPH. 

About IDSA
The Infectious Diseases Society of America is a community of over 13,000 physicians, scientists and public health experts who specialize in infectious diseases. Its purpose is to improve the health of individuals, communities and society by promoting excellence in patient care, education, research, public health and prevention relating to infectious diseases. Learn more at idsociety.org.

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