Context

The prevention and treatment of complicated intra-abdominal infections have remained a priority for surgeons for decades, importantly including adequate source control.1 While evidence supports the early initiation of antimicrobial therapy,2 questions remain about the appropriate extent of therapy. Systemic inflammatory response syndrome (SIRS)-related signs of sepsis have dictated duration. However, signs of SIRS may persist without any evidence of infection. The corollary is also true as up to 12.5% of patients with severe sepsis may indeed be SIRS negative.3 Sawyer and colleagues previously demonstrated that a fixed duration of antimicrobial therapy yielded similar outcomes with less antibiotic use.4 Clinicians have historically treated complicated intra-abdominal infections for up to 14 days, although practice guidelines recommend 4–7 days. …