De Waele Jan J
Department of Critical Care Medicine, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
Curr Infect Dis Rep. 2016 Aug;18(8):23. doi: 10.1007/s11908-016-0531-z.
Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy.
腹部感染对重症监护医生来说是一项重大挑战。在抗菌药物耐药性不断增加的时代，选择合适的治疗方案很重要，而且随着新药上市，正确使用比以往任何时候都更加重要，腹部感染是抗菌药物管理计划的一个理想目标。生物标志物可能会有所帮助，但其在腹部感染管理中的确切作用仍未完全明确。源头控制仍是一个持续存在的难题，而且越来越多的证据表明其重要性超过了抗生素治疗的影响。诸如开放性腹腔管理等新策略可能会给重症患者带来额外益处，但需要更多数据来确定其确切作用。另一方面，近年来对真菌的作用以及抗真菌治疗的必要性进行了广泛研究，但目前仍不清楚哪些患者需要经验性治疗以及针对性治疗。
