For high-risk community-acquired abdominal infections in adults, several effective medications are recommended as empiric treatments. These medications are often used initially while awaiting specific culture results.
Antibiotics for Abdominal Infections
The following antibiotics, often used in combination, are effective against a wide range of bacteria that can cause abdominal infections.
Recommended Empiric Regimens:
| Antibiotic Class | Specific Medications | Notes |
|---|---|---|
| Carbapenems | meropenem, imipenem–cilastatin, doripenem | Broad-spectrum antibiotics, usually reserved for severe infections or those resistant to other antibiotics. |
| Penicillin/Beta-Lactamase Inhibitor | piperacillin–tazobactam | A combination antibiotic that covers a wide range of bacteria, including those that produce beta-lactamase, an enzyme that can make some antibiotics less effective. |
| Fluoroquinolones & Metronidazole | ciprofloxacin or levofloxacin combined with metronidazole | Fluoroquinolones (ciprofloxacin and levofloxacin) are broad-spectrum antibiotics, and metronidazole is effective against anaerobic bacteria commonly found in abdominal infections. |
| Cephalosporins & Metronidazole | ceftazidime or cefepime combined with metronidazole | Cephalosporins are another class of broad-spectrum antibiotics, and when combined with metronidazole, they offer extensive coverage for most abdominal infections. |
Additional Considerations:
- Empiric treatment means the antibiotics are started before the specific bacteria causing the infection is identified. This is critical to start treatment quickly, especially in severe cases.
- High-risk infections often include infections with signs of severe sepsis, infections in immunocompromised patients, or infections after abdominal surgery.
- Metronidazole is often paired with other drugs listed above, as it specifically works against anaerobic bacteria which are common culprits in abdominal infections.
- Specific identification: Once the specific bacteria causing the infection is identified through cultures, the antibiotic regimen may be modified for a more targeted approach.
It is important to consult with a healthcare professional for proper diagnosis and treatment of any abdominal infection, as self-treatment can be harmful.
