DiPiro J T
University of Georgia College of Pharmacy, Augusta, USA.
Pharmacotherapy. 1995 Jan-Feb;15(1 Pt 2):15S-21S.
Intraabdominal infections are a wide range of diseases that include penetrating abdominal trauma, appendicitis, peritonitis, and abscess. Most are polymicrobic, involving aerobic and anaerobic bacteria. The primary treatment is surgery, but important issues regarding administration of antimicrobials may affect patient outcome. Evaluation of an antimicrobial regimen must include consideration of outcomes--survival, organ failure, adverse drug effects, and superinfection. Single-agent regimens have demonstrated benefit in patients with acute intraabdominal contamination and established infections. Guidelines for selecting antimicrobial agents are available from the Surgical Infection Society. Regimens are effective when active against most bacteria isolated from the focus of abdominal infection. The patient's clinical response, not culture results independent of clinical findings, is the primary guide for directing changes in therapy.
腹腔内感染是一系列疾病，包括腹部穿透伤、阑尾炎、腹膜炎和脓肿。大多数感染是多菌性的，涉及需氧菌和厌氧菌。主要治疗方法是手术，但抗菌药物的使用相关重要问题可能会影响患者的预后。对抗菌治疗方案的评估必须包括对预后的考量——生存、器官衰竭、药物不良反应和二重感染。单药治疗方案已被证明对急性腹腔内污染和已确诊感染的患者有益。外科感染协会提供了选择抗菌药物的指南。当治疗方案对从腹部感染病灶分离出的大多数细菌有活性时，即为有效。指导治疗方案调整的主要依据是患者的临床反应，而非独立于临床发现的培养结果。
