Strategy of diagnosis and management of intra-abdominal infection after gastrointestinal surgery            ZHAO  Yun-zhao. Department of General Surgery, Nanjing General Hospital of Nanjing Military Command, Nanjing 210002, China
Abstract    Intra-abdominal infection after gastrointestinal operation has become an important cause of morbidity and are frequently associated with poor prognosis. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures. The key point in the management of complicated intra-abdominal infections is both source control and antibiotic therapy. The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections. Empiric antimicrobial therapy is important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance. A deescalation approach may be recommended in patients with specific risk factors for multidrug resistant infections such as immunodeficiency and prolonged antibacterial exposure.