Table 2B. Agents and Regimens that may be Used for Treatment of Extra-Biliary Complicated Intra-Abdominal Infections
Community-Acquired Infections in Adults Mild-to-Moderate
> Cefoxitin > Ertapenem > Moxifloxacin > Tigecycline† > Ticarcillin/clavulanic acid
> Cefazolin,* cefuroxime, ceftriaxone, cefotaxime, ciprofloxacin, or levofloxacin, each in combination with metronidazole
Severe
> Imipenem/cilastatin > Meropenem > Doripenem > Piperacillin/tazobactam
> Cefepime, ceftazidime, ciprofloxacin, or levofloxacin, each in combination with metronidazole
* Caution—local antibiograms should direct use of this agent. †
An 0.6% increase in mortality has been found in a pooled analysis of all patients treated with tigecycline in clinical trials.
Table 2C. Recommendations for Empiric Antimicrobial Therapy for Health Care-Associated Complicated Intra- Abdominal Infections Based Upon Local ICU Specific Microbiology for Health Care-Associated Infections
Carbapenem (Imipenem/ cilastatin,
meropenem, or doripenem)
+
Piperacillin/ Tazobactam
+
ESBL-producing Enterobacteriaceae +
+
P. aeruginosa > 20% resistant to ceftazidime +
+ MRSA − − − − − Indicates that the listed agent or class is not recommended for use in this circumstance. +
+ Indicates that the listed agent or class is recommended for empiric use, before culture and susceptibility data are available.
Ceftazidime or cefepime, each with
metronidazole Aminoglycoside Vancomycin
< 20% resistant Pseudomonas aeruginosa, ESBL-producing Enterobacteriaceae, Acinetobacter or other MDR GNR
+ − − − + +
Combination regimen
Single agent
