In this episode, we dive into the 2024 guidelines from the Surgical Infection Society (SIS). Using a case-based approach, we explore how the updated guidelines impact clinical decision-making in the management of intra-abdominal infections. Our expert guests break down best practices while emphasizing the importance of timely intervention, appropriate antibiotic selection, and the evolving role of local antibiograms in guiding therapy. Listeners will gain practical insights into the newest evidence-based recommendations, including when to shorten antibiotic courses, how to tailor therapy for individual patients, and the critical need for early source control. Whether you're a seasoned clinician or a trainee, this case-based discussion provides actionable takeaways for improving patient outcomes in surgical infections.

Take Home Points: 

- Antibiotics and antibiotic resistance are continuously evolving. It’s essential to stay updated with current guidelines, consult your local antibiogram, and utilize available antimicrobial options to create an informed and effective treatment plan

- Shorter course antibiotics for intra-abdominal infections are generally well tolerated, but careful patient selection is crucial for optimizing outcomes.  

- In cases of complicated appendicitis, antibiotics should be discontinued within 24-48 hours after effective source control is achieved. 

- Time is life – early administration of appropriate antibiotics and prompt, definitive source control are key to improving patient outcomes 

Hosts: 

- Patrick Georgoff, MD – Trauma Surgeon at Duke University, @georgoff

- Nicole Petcka, MD – General Surgery Resident at Emory University, @npetcka2022

Guests: 

- Heather Evans, MD, MS – Chief of Surgery at the Ralph H. Johnson VA Medical Center, President of the Surgical Infection Society 

- Joe Forrester, MD, MSc – Assistant Professor of Surgery at Stanford University, Surgical Infection Society Therapeutics and Guidelines Committee Chair 

Resources: 

The Surgical Infection Society Guidelines on the Management of Intra-Abdominal Infection: 2024 Update

Huston JM, Barie PS, Dellinger EP, Forrester JD, Duane TM, Tessier JM, Sawyer RG, Cainzos MA, Rasa K, Chipman JG, Kao LS, Pieracci FM, Colling KP, Heffernan DS, Lester J; Therapeutics and Guidelines Committee. The Surgical Infection Society Guidelines on the Management of Intra-Abdominal Infection: 2024 Update. Surg Infect (Larchmt). 2024 Aug;25(6):419-435. doi: 10.1089/sur.2024.137. Epub 2024 Jul 11. PMID: 38990709.

https://pubmed.ncbi.nlm.nih.gov/38990709/

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