Analytical Framework for Examining the Value of Antibacterial Products. A.4.2 Current Treatment


CIAIs are likely to be managed in an inpatient setting, as successful treatment is dependent on both source control (e.g., surgical drainage and definitive management of the source) and antimicrobial treatment.

For IAIs, the location of the primary source of infection, the presence of comorbidities, and whether the infection is community-acquired or healthcare-associated are critical factors in predicting antibacterial drug susceptibilities.  Healthcare-associated CIAIs are frequently associated with more resistant flora. Complicated IAIs can be treated with either single agent or combination therapy antimicrobials. Agents approved for use include ticarcillin-clavulanate, cefoxitin, moxifloxacin, ertapenem, and tigecycline.  The empiric use of antimicrobial regimens such as  meropenem, imipenem-cilastatin, doripenem, piperacillin-tazobactam, ciprofloxacin or levofloxacin in combination with metronidazole, or ceftazidime or cefepime in combination with metronidazole, is recommended for patients with high-severity community-acquired intra-abdominal infection.

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