The published clinical research in 2018 in surgical infection are changing current opinions in the management of acute appendicitis, antibiotics usage, resuscitation of septic shock, and choice of nutritional therapy in critically ill patients. In the management of uncomplicated acute appendicitis, antibiotic therapy can be successful in selected patients who wish to avoid surgery. Delayed primary wound closure can not reduce superficial surgical site infection rates compared to primary wound closure for complicated appendicitis. Infusion of antibiotics 30 minutes before the start of operation may influence their prophylactic effect on surgical site infection. After adequate source control, long-course antibiotic therapy in critically ill post-operative patients is not associated with any clinical benefit. Although susceptible in the test, piperacillin-tazobactam can not replace carbapenems in patients with Escherichia coli and Klebsiella pneumoniae bloodstream infection that produce extended-spectrum beta-lactamase for definitive treatment. Deresuscitation of critically ill patients is associated with reduced mortality. Hydrocortisone therapy has potential role in the patients with septic shock and worth further evidence. The use of an energy-dense formulation for enteral delivery of nutrition can not improve 90-day survival rate in patients undergoing mechanical ventilation. Compared with early isocaloric parenteral nutrition, early enteral nutrition did not reduce mortality or the risk of secondary infections, but was associated with a greater risk of digestive complications in critically ill adults with septic shock.
Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Appendicitis ; complications ; therapy ; Critical Illness ; Humans ; Nutritional Support ; Shock, Septic ; etiology ; therapy ; Surgical Wound Infection ; etiology ; prevention & control ; therapy