New antimicrobial options for the management of complicated intra-abdominal infections

  • Sebastiano LeoneEmail author
  • Giovanni Damiani
  • Ilaria Pezone
  • Molly E. Kelly
  • Marco Cascella
  • Aniello Alfieri
  • Maria C. Pace
  • Marco Fiore


Complicated intra-abdominal infections (cIAIs) are a common cause of morbidity and mortality in surgical patients. Optimal management of cIAI requires early source control in combination with adequate antimicrobial treatment and aggressive fluid resuscitation. cIAIs are mainly caused by Gram-negative bacilli and anaerobes. Broad-spectrum single-agent or combination drug regimens against these microorganisms are the mainstay of therapy. However, development of antimicrobial resistance has become an increasingly large concern: multidrug-resistant organisms are associated with a higher rate of inadequate antimicrobial therapy, which in turn is associated with higher mortality rate, longer hospital stay, and increased cost compared to adequate antimicrobial therapy. In this mini-review, we discuss the effectiveness of several new antimicrobial agents, recently approved or in advanced phases of clinical development, for the treatment of cIAIs, including the new beta-lactam and beta-lactamase inhibitor combinations (ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, imipenem/cilastatin/relebactam, aztreonam/avibactam), siderophore cephalosporins (cefiderocol), aminoglycosides (plazomicin), and tetracyclines (eravacycline).


Intra-abdominal infections Antimicrobial resistance Antimicrobial therapy New antimicrobial agents 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Not required.

Informed consent

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Sebastiano Leone
    • 1
    Email author
  • Giovanni Damiani
    • 2
  • Ilaria Pezone
    • 3
  • Molly E. Kelly
    • 4
  • Marco Cascella
    • 5
  • Aniello Alfieri
    • 6
  • Maria C. Pace
    • 6
  • Marco Fiore
    • 6
  1. 1.Division of Infectious Diseases, Contrada Amoretta“San Giuseppe Moscati” HospitalAvellinoItaly
  2. 2.Department of Pathophysiology and TransplantationUniversity of Milan, Fondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoMilanItaly
  3. 3.Department of Pediatrics“San Giuseppe Moscati” HospitalAversa CEItaly
  4. 4.Case Western Reserve University School of MedicineClevelandUSA
  5. 5.Department of Support for Clinical Activities and Critical Area, Division of Anesthesia and Pain MedicineIstituto Nazionale Tumori - IRCCS “Fondazione G. Pascale”NaplesItaly
  6. 6.Department of Anaesthesiological, Surgical and Emergency SciencesUniversity of Campania “Luigi Vanvitelli”NaplesItaly

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