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However, glycopeptides including vancomycin and teicoplanin are not mentioned at all in their statements. However, after tracking the two supporting references in the text, 16 , 17 we conclude that this statement is based on in vitro data of anti-enterococcus activities of vancomycin, instead of clinical comparative cohort study. Therefore, there is still a lack of direct clinical evidences of vancomycin in the management of IAIs.

Asia is an Asian perspective in antibiotic management of complicated IAIs in adults. In this perspective, vancomycin is only mentioned once where it is recommended as an adjuvant drug to carbapenems in the treatment of severe health care-associated complicated IAIs.

Clinician’s Manual on Intra-abdominal Infections

Vancomycin is not mentioned as an exclusive antimicrobial in the management of IAIs. Nevertheless, the panel has discussed in the text that their recommendation regarding the use of vancomycin in Enterococcus spp. They admit that there is no specific data regarding the efficacy of antibiotics in treating intra-abdominal MRSA infection. The exclusion criteria were peritoneal dialysis study, animal study, epidemiology study, nonadult pediatrics study, nonoriginal publication review, editorial , and informal publication conference abstract.

We conducted an additional manual retrieval of relevant original references from current guidelines. Figure 1 demonstrates the flowchart of eligible studies. A total of 1, references were identified, of which were subsequently screened after removal of duplicates. The remaining 29 articles together with 25 additional articles by manual retrieval from current guidelines were assessed for eligibility.

Eventually, no eligible study remained for systematic review Figure 1. Figure 1 The flow chart of literature search for the exclusive use of vancomycin in intra-abdominal infections. To summarize, the above six guidelines consistently recommend the exclusive use of vancomycin in two indications: IAIs caused by Enterococcus spp. Furthermore, after conducting literature search for eligible clinical studies, we discover that high-level evidence regarding the exclusive therapy of vancomycin in the treatment of IAIs is absent, and current low-level evidences are inadequate to elicit strong recommendations on the exclusive use of vancomycin in the treatment of IAIs.

Our study would be helpful for rational use of vancomycin and deceleration of the emerging vancomycin resistance rates. Compared to monotherapy, inclusion of vancomycin as part of broad-spectrum coverage failed to result in better clinical cure or reduced mortality, 22 but even longer length of stay in intensive care unit. The patent expired in early s. Since then, several generic versions from various manufacturers have been authorized by FDA for the sale of vancomycin.

We assume that the lack of industry-driven clinical trials in recent 30 years contributes to the deficiency of clinical evidences in this area. We believe that future randomized clinical studies are necessary to verify current recommendations and develop new scenarios in which exclusive vancomycin is appropriate for the management of IAIs. The authors lament the decease of the dearest friend Dr. Menichetti F, Sganga G.

Definition and classification of intra-abdominal infections.

J Chemother. Sartelli M. A focus on intra-abdominal infections.


  • [Full text] Vancomycin in the treatment of adult intra-abdominal infections: do we | IDR.
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  • Background!

World J Emerg Surg. Source control review in clinical trials of anti-infective agents in complicated intra-abdominal infections.

Description

Clin Infect Dis. Boneca IG, Chiosis G. Vancomycin resistance: occurrence, mechanisms and strategies to combat it. Expert Opin Ther Targets. Antibiotics for treatment of resistant Gram-positive coccal infections. Indian J Pediatr. Historical yearly usage of vancomycin. Antimicrob Agents Chemother. Centers for Disease Control and Prevention. Summary of notifiable diseases, United States Emergence of vancomycin tolerance in Streptococcus pneumoniae.

Staphylococcus aureus resistant to vancomycin — United States, The Surgical Infection Society revised guidelines on the management of intra-abdominal infection. Surg Infect. The management of intra-abdominal infections from a global perspective: WSES guidelines for management of intra-abdominal infections. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections AGORA. Guidelines for management of intra-abdominal infections. Anaesth Crit Care Pain Med.

Vancomycin in the treatment of adult intra-abdominal infections: do we have strong evidences?

Antibiotic management of complicated intra-abdominal infections in adults: the Asian perspective. Ann Med Surg. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America.

Clinical and microbiological profiles of community-acquired and nosocomial intra-abdominal infections: results of the French prospective, observational EBIIA study.

Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis

J Antimicrob Chemother. Risk factors for multidrug resistant bacteria and optimization of empirical antibiotic therapy in postoperative peritonitis. Crit Care.

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