When Should Antimicrobial Therapy Be Initiated for Patients with Suspected or Confirmed Intra-abdominal Infection?
• Antimicrobial therapy should be initiated once a patient receives a diagnosis of an intra-abdominal infection or once such an infection is considered likely. For patients with septic shock, antibiotics should be administered as soon as possible (A-III). • For patients without septic shock, antimicrobial therapy should be started in the emergency department (B-III). • Satisfactory antimicrobial drug levels should be maintained during a source control intervention, which may necessitate additional administration of antimicrobials just before initiation of the procedure (A-I). What Are the Proper Procedures for Obtaining Adequate Source Control? • An appropriate source control procedure to drain infected foci, control ongoing peritoneal contamination by diversion or resection, and restore anatomic and physiological function to the extent feasible is recommended for nearly all patients with intra-abdominal infection (B-II). • Patients with diffuse peritonitis should undergo an emergency
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