Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.
Massimo Sartelli, Dieter Weber, Etienne Ruppé, Matteo Bassetti, Brian Wright, Luca Ansaloni, Fausto Catena, Federico Coccolini, Fikri Abu-Zidan, Raul Coimbra, Ernest Moore, Frederick Moore, Ronald Maier, Jan De Waele, Andrew Kirkpatrick, Ewen Griffiths, Christian Eckmann, Adrian Brink, John Mazuski, Addison May, Rob Sawyer, Dominik Mertz, Philippe Montravers, Anand Kumar, Jason Roberts, Jean-Louis Vincent, Richard Watkins, Warren Lowman, Brad Spellberg, Iain Abbott, Abdulrashid Adesunkanmi, Sara Al-Dahir, Majdi Al-Hasan, Ferdinando Agresta, Asma Althani, Shamshul Ansari, Rashid Ansumana, Goran Augustin, Miklosh Bala, Zsolt Balogh, Oussama Baraket, Aneel Bhangu, Marcelo Beltrán, Michael Bernhard, Walter Biffl, Marja Boermeester, Stephen Brecher, Jill Cherry-Bukowiec, Otmar Buyne, Miguel Cainzos, Kelly Cairns, Adrian Camacho-Ortiz, Sujith Chandy, Asri Che Jusoh, Alain Chichom-Mefire, Caroline Colijn, Francesco Corcione, Yunfeng Cui, Daniel Curcio, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Sameer Dhingra, José Diaz, Isidoro Di Carlo, Angel Dillip, Salomone Di Saverio, Michael Doyle, Gereltuya Dorj, Agron Dogjani, Hervé Dupont, Soumitra Eachempati, Mushira Enani, Valery Egiev, Mutasim Elmangory, Paula Ferrada, Joseph Fitchett, Gustavo Fraga, Nathalie Guessennd, Helen Giamarellou, Wagih Ghnnam, George Gkiokas, Staphanie Goldberg, Carlos Gomes, Harumi Gomi, Manuel Guzmán-Blanco, Mainul Haque, Sonja Hansen, Andreas Hecker, Wolfgang Heizmann, Torsten Herzog, Adrien Hodonou, Suk-Kyung Hong, Reinhold Kafka-Ritsch, Lewis Kaplan, Garima Kapoor, Aleksandar Karamarkovic, Martin Kees, Jakub Kenig, Ronald Kiguba, Peter Kim, Yoram Kluger, Vladimir Khokha, Kaoru Koike, Kenneth Kok, Victory Kong, Matthew Knox, Kenji Inaba, Arda Isik, Katia Iskandar, Rao Ivatury, Maurizio Labbate, Francesco Labricciosa, Pierre-François Laterre, Rifat Latifi, Jae Lee, Young Lee, Marc Leone, Ari Leppaniemi, Yousheng Li, Stephen Liang, Tonny Loho, Marc Maegele, Sydney Malama, Hany Marei, Ignacio Martin-Loeches, Sanjay Marwah, Amos Massele, Michael McFarlane, Renato Melo, Ionut Negoi, David Nicolau, Carl Nord, Richard Ofori-Asenso, AbdelKarim Omari, Carlos Ordonez, Mouaqit Ouadii, Gerson Pereira Júnior, Diego Piazza, Guntars Pupelis, Timothy Rawson, Miran Rems, Sandro Rizoli, Claudio Rocha, Boris Sakakhushev, Miguel Sanchez-Garcia, Norio Sato, Helmut Segovia Lohse, Gabriele Sganga, Boonying Siribumrungwong, Vishal Shelat, Kjetil Soreide, Rodolfo Soto, Peep Talving, Jonathan Tilsed, Jean-Francois Timsit, Gabriel Trueba, Ngo Trung, Jan Ulrych, Harry van Goor, Andras Vereczkei, Ravinder Vohra, Imtiaz Wani, Waldemar Uhl, Yonghong Xiao, Kuo-Ching Yuan, Sanoop Zachariah, Jean-Ralph Zahar, Tanya Zakrison, Antonio Corcione, Rita Melotti, Claudio Viscoli, Perluigi Viale.
Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA),
World Journal of Emergency Surgery,
2016, pp. 33, 11, DOI: 10.1186/s13017-016-0089-y