title: Perioperative Antibiotic Prophylaxis and Antimicrobial Therapy of Intra-Abdominal Infections.
abstract: BACKGROUND
  The increase of antimicrobial resistances to first- and second-line antibiotics, especially of Gram-negative bacteria, and the lack of novel antimicrobial substances are a challenge in the treatment of intra-abdominal infections.
  
  
  METHODS
  Review article.
  
  
  RESULTS
  The efficacy and safety of perioperative antibiotic prophylaxis in visceral surgery has been demonstrated by several meta-analyses. Perioperative antibiotic prophylaxis is defined as a single administration of antibiotics shortly before a surgical intervention. A so-called prolonged prophylaxis including the postoperative period (e.g. 1-3 days postoperatively) should be avoided as it does not reduce the number of wound infections and is associated with an increased risk of antimicrobial resistance and side effects. Antimicrobial management of severe intra-abdominal infections involves a delicate balance of optimizing empirical therapy which has been shown to improve outcomes while simultaneously reducing unnecessary use of antimicrobials.
  
  
  CONCLUSIONS
  Antimicrobial resistance poses a serious threat to human health and requires a rational use of antibiotics to curb further spreading. This applies for perioperative prophylaxis as well as for the treatment of intra-abdominal infections.
authors.affiliation: Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany, ; Department of Internal Medicine IV, Gastroenterology, Hepatology and Infectious Diseases, Jena University Hospital, Jena, Germany, ; Center for Sepsis Control & Care (CSCC), Jena University Hospital, Jena, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hagel
authors.affiliation: Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany.
authors.forename: Hubert
authors.initials: H
authors.lastname: Scheuerlein
keywords: Antibiotic resistance; Intra-abdominal infections; Perioperative antibiotic prophylaxis