Guidelines
Non-Biliary Infections

Non-Biliary Infections

Guideline Use

Utilize the Severe Sepsis/Septic Shock guidelines

Dose recommendations are based on patients with normal renal function. Refer to dosing in renal impairment

These guidelines may not be appropriate for patients with a history of multi-drug resistant organisms. Consider infectious disease consultation

Includes appendicitis / diverticulitis

Diagnostics

Antibiotic selection should be guided by cultures where available; empiric choices in this guideline are based on local susceptibilities

Management Considerations

Enterococcus isolated from mixed cultures in mild-moderate infections are of unclear significance and typically do not require targeted therapy

Yeast, if isolated, should be treated

Treatment

  • Community onset, or
  • Hospitalized < 48 hours
  • Hospitalized > 48 hours, or
  • Post-operative

Additional Information

These recommendations are meant to guide empiric therapeutic decision making and are not meant to replace sound clinical decision making. Definitive therapy should be based on culture and susceptibility reports

  • Kyle D. Massey, PharmD

  • Rebekah Gass, MD

  • 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: 133-64. Pubmed
  • Regimbeau JM, Fuks D, Pautrat K, et al., for the FRENCH Study Group. Effect of postoperative antibiotic administration on postoperative infection following cholecystectomy for acute calculous cholecystitis: a randomized clinical trial. JAMA 2014; 312: 145-54. Pubmed
  • Mazuki JE, Tessier JM, May AK, et al. The surgical infection society revised guidelines on the management of intra-abdominal infection. Surgical infections 2017; 18: 1-76 Pubmed
  • Sawyer RG, Claridge JA, Nathens AB et al. Trial of short-course antimicrobial therapy for intraabdominal infection. NEJM 2015; 372: 1996-2005 Pubmed