2024 Guidelines from the Surgical Infection Society (SIS)

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 5 December 2024

⏱️ 31 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, we dive into the 2024 guidelines from the Surgical Infection Society (SIS). Using a case-based approach, we explore how the updated guidelines impact clinical decision-making in the management of intra-abdominal infections. Our expert guests break down best practices while emphasizing the importance of timely intervention, appropriate antibiotic selection, and the evolving role of local antibiograms in guiding therapy. Listeners will gain practical insights into the newest evidence-based recommendations, including when to shorten antibiotic courses, how to tailor therapy for individual patients, and the critical need for early source control. Whether you're a seasoned clinician or a trainee, this case-based discussion provides actionable takeaways for improving patient outcomes in surgical infections.

Take Home Points:
- Antibiotics and antibiotic resistance are continuously evolving. It’s essential to stay updated with current guidelines, consult your local antibiogram, and utilize available antimicrobial options to create an informed and effective treatment plan
- Shorter course antibiotics for intra-abdominal infections are generally well tolerated, but careful patient selection is crucial for optimizing outcomes.
- In cases of complicated appendicitis, antibiotics should be discontinued within 24-48 hours after effective source control is achieved.
- Time is life – early administration of appropriate antibiotics and prompt, definitive source control are key to improving patient outcomes

Hosts:
- Patrick Georgoff, MD – Trauma Surgeon at Duke University, @georgoff
- Nicole Petcka, MD – General Surgery Resident at Emory University, @npetcka2022

Guests:
- Heather Evans, MD, MS – Chief of Surgery at the Ralph H. Johnson VA Medical Center, President of the Surgical Infection Society
- Joe Forrester, MD, MSc – Assistant Professor of Surgery at Stanford University, Surgical Infection Society Therapeutics and Guidelines Committee Chair

Resources:
The Surgical Infection Society Guidelines on the Management of Intra-Abdominal Infection: 2024 Update

Huston JM, Barie PS, Dellinger EP, Forrester JD, Duane TM, Tessier JM, Sawyer RG, Cainzos MA, Rasa K, Chipman JG, Kao LS, Pieracci FM, Colling KP, Heffernan DS, Lester J; Therapeutics and Guidelines Committee. The Surgical Infection Society Guidelines on the Management of Intra-Abdominal Infection: 2024 Update. Surg Infect (Larchmt). 2024 Aug;25(6):419-435. doi: 10.1089/sur.2024.137. Epub 2024 Jul 11. PMID: 38990709.
https://pubmed.ncbi.nlm.nih.gov/38990709/

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Transcript

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0:00.0	Behind the Knife, THE Surgery Podcast Petka, a general surgery resident at Emory
0:26.4	University and one of the Behind the Knife Surgical Education Fellows. I'm here with Patrick
0:30.4	Georgeoff, trauma surgeon at Duke University. To start off, I want to set the scene for today's
0:34.7	episode. Imagine you're coming in for morning rounds and you hear that one of your patients whose post-op day five had a fever overnight.
0:41.1	The night team obtained CT imaging, which showed an intra-abdominal abscess. You know that you need
0:45.5	to start antibiotics, but what antibiotics do you choose? Do you find yourself always picking the same ones?
0:50.6	What's the evidence behind your favorite antibiotic combination? We're going to cover all of this and more today as we go over the Surgical Infection Society Guidelines on the Management of Intraudominal Infections, 2014 Update.
1:01.0	We have two special guests with us here today. First is Dr. Heather Evans. Dr. Evans is chief of surgery at the Ralph H. Johnson VA Medical Center and a professor of surgery at the Medical
1:10.8	University of South Carolina in Charleston. Dr. Evans attended her first SIS meeting in 2001,
1:16.8	when she was a second-year general surgery resident at the University of Virginia, and just
1:20.9	beginning her clinical research career in surgical infections with Dr. Robert Sawyer. Little did she know
1:25.6	at the time, but she would go on to attend and present at every annual
1:28.5	meeting of the SIS, missing only one in 23 years, and become the society's 44th president
1:33.6	this year.
1:34.8	Dr. Evans is the national leader in infection control research with a clinical expertise
1:38.7	in surgical infections and a research specialization in the application of digital health solutions
1:43.7	by leveraging multidisciplinary teams to improve post-operative post-discharge care experience.
1:49.0	For over two decades, she has explored the application of technology, telemedicine, and patient-centered care to the diagnosis and treatment of surgical infections.
1:57.0	Our second guest is Dr. Jo Forrester. Dr. Forrester is an assistant professor of surgery at Stanford University, the trauma
2:03.6	medical director at Stanford Healthcare, and the medical director of Stanford's
2:07.6	Chesswall Injury Center.
2:08.6	He is also the associate chair of clinical affairs where he helps oversee all of the department's
	...

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