To the Editor,

I read with interest the letter by Dr Chong regarding my review on abdominal infections [1].

I am grateful to him for highlighting the importance of the variability in pathogens that cause intra abdominal infections at different parts of the world and the need of adjusting the diagnosis and treatment to each country.

However, I would like to emphasize that anaerobic bacteria also play a role in these infections in all countries even though the aerobic and facultative bacteria may vary. This is because anaerobes are part of the gastrointestinal flora of individuals all over the world. The only way to find out the true prevalence of organisms and unique anaerobes in each country is to perform studies where these organisms are adequately looked for by using proper methods of collection, transportation of specimens, and cultivation.

I am hopeful that such studies are performed in all countries as searching for anaerobic bacteria is more laborious and requires special equipment and is more expensive.

It is prudent in my experience to treat all patients in all countries with abdominal infections especially after perforation of the gut or abdominal trauma, also with antibiotics effective against anaerobic bacteria.