Vyhnánek F
Chirurgická klinika 3. LF UK, Praha.
Rozhl Chir. 2009 Apr;88(4):206-13.
Compared to other infections, intraabdominal infections include wide spectrum of infections of various severity, have different ethiology, which is frequently polymicrobial, show different microbiological results, which are difficult to interpret. The role of surgical intervention is essential. Intraabdominal infections are common causes of morbidity and mortality. Their prognosis is significantly improved with early and exact diagnosis, appropriate surgical or radiological intervention and timely effective antimicrobial therapy. Practitioners may choose between older or more modern antibiotics, between monotherapy or combination therapy, however, they should also consider clinical condition of the patient, the antibiotic's spectrum of activity, the treatment timing and its duration, the dose and dosing scheme of the particular antimicrobials. Furthermore, antimicrobial therapy should be used with caution, with the aim to prevent development of antimicrobial resistence. Inappropriate choice of antimicrobials in initial empiric therapy results in relapsing infections, surgical intervention and prolongation of hospitalization, and even death rates reflect adequate and timely empiric therapy.
与其他感染相比，腹腔内感染包括各种严重程度的广泛感染，病因不同，通常为多微生物感染，微生物学结果各异且难以解释。手术干预的作用至关重要。腹腔内感染是发病和死亡的常见原因。早期准确诊断、适当的手术或放射学干预以及及时有效的抗菌治疗可显著改善其预后。从业者可以在较老的或更现代的抗生素之间、单药治疗或联合治疗之间进行选择，然而，他们还应考虑患者的临床状况、抗生素的活性谱、治疗时机及其持续时间、特定抗菌药物的剂量和给药方案。此外，抗菌治疗应谨慎使用，以防止产生抗菌耐药性。初始经验性治疗中抗菌药物选择不当会导致感染复发、手术干预和住院时间延长，甚至死亡率也反映了充分及时的经验性治疗情况。
