Antimicrobial Treatmdent of "Complicated" Intra-Abdominal Infections and The New IDSA Guidelines - A Commentary and an Alternative European Approach According to Clinical Definitions

Table 4 Recommendations for the initial therapy of tertiary peritonitis.

Diagnosis	Likely organism	Initial therapy	Level of evidence	Strength of recommendation
Persisting peritonitis despite adequate surgical and initial antimicrobial therapy	Enterobacteriaceae (Enterococci) (Staphylococci)	Imipenem-Cilastatin	2	A
		Meropenem	2	A
		Acylaminopenicillin/BLI	2	A
	Anaerobes	Tigecycline#	2	A
		Ertapenem#	4	B
		Ceftriaxone+Metronidazole	4	B
	MRSA, VRE ESBL Pseudomonas spp.	see Table 5
	Candida spp.	see Table 6

# = combination therapy with pseudomonas-active agent required if Pseudomonas is suspected

ISSN: 2047-783X