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Appendix M: Guidelines for the Prophylaxis and Management of
Intraabdominal, Biliary, and Appendiceal Infections
University of Wisconsin Hospital and Clinics
Intraabdominal Infections – Prophylaxis and Management
Guidelines developed by: Barry Fox, MD
Reviewed and approved by: Surgical QA Committee, Antimicrobial Use
Approved by P&T:
Scheduled for Review
A. Background
B. Surgical Prophylaxis
C. Source Control
D. Categorization
E. Treatment by Category
F. Cholangitis and Cholecystitis
G. Duration of therapy
H. Necrotizing Pancreatitis
A. Background
This guideline is intended to provide evidence-based guidance for surgical
prophylaxis and the treatment of intraabdominal infections. It is based on the
2009 revision of the Infectious Diseases Society of America/Surgical Infection
Society update of their joint guideline.1 The guideline is stratified according to
the severity of infection and risk of treatment failure, and antimicrobial
recommendations are targeted accordingly.
B. Surgical Prophylaxis
The UWHC Antimicrobial Use Guidelines (AMUG) include a section on surgical
antimicrobial prophylaxis.2 Use of the appropriate antimicrobial regimen for the
appropriate duration is of paramount importance in gastrointestinal surgeries.
Table 1 shows the prophylaxis regimens recommended in the AMUG.