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Relapse after complicated intra-abdominal infection (cIAI) remains common after treatment. The optimal antibiotic treatment duration for cIAIs is uncertain, especially in cases where source control is not achieved. We hypothesised that in patients with cIAIs, regardless of source control intervention, there would be a lower relapse rate with long-course antibiotics (28 days) compared with short course (≤ 10 days). We piloted a trial comparing ≤ 10-day with 28-day antibiotic treatment for cIAI. A randomised controlled unblinded feasibility trial was conducted. Eligible participants were adult patients with a cIAI that were diagnosed ≤ 6 days prior to screening. Randomisation was to long-course (28 days) or short-course (≤10 days) antibiotic therapy. Choice of antibiotics was determined by the clinical team. Participants were followed up for 90 days. Primary outcomes were willingness of participants to be randomised and feasibility of trial procedures. In total, 172 patients were screened, 84/172 (48.8%) were eligible, and 31/84 (36.9%) were randomised. Patients were assigned to either the short-course arm (18/31, 58.0%) or the long-course arm (13/31, 41.9%). One patient in the short-course arm withdrew after randomisation. In the short-course arm, 4/17 (23.5%) were treated for a cIAI relapse vs 0/13 (0.0%) relapses in the long-course arm. Protocol violations included deviations from protocol-assigned antibiotic duration and interruptions to antibiotic therapy. This feasibility study identified opportunities to increase recruitment in a full trial. This study demonstrates completion of a randomised controlled trial to further evaluate if the optimum antibiotic duration for cIAIs is feasible. ClinicalTrials.gov Identifier: NCT03265834

This chapter evaluates the environment from a far more detailed perspective than is usual. It especially draws attention to the social and behavioural issues that have to be considered. There is a far more detailed method proposed for addressing and classifying the different environmental factors that are of value to society as well as delivering the economic demands necessary.

This chapter summarises the foundations of management knowledge and expertise so as to provide a foundation and context for the rest of the book. This is defined from the point of view of what is a more or less agreed body of knowledge and expertise as established to date. This is then in turn set in the context of the world as it is at present, with especial reference to the restructuring of businesses, business and the economic and social world order as it emerges from the COVID19 pandemic.

Relapse after complicated intra-abdominal infection (cIAI) remains common after treatment. The optimal antibiotic treatment duration for cIAIs is uncertain, especially in cases where source control is not achieved. We hypothesised that in patients with cIAIs, regardless of source control intervention, there would be a lower relapse rate with long-course antibiotics (28 days) compared with short course (≤ 10 days). We piloted a trial comparing ≤ 10-day with 28-day antibiotic treatment for cIAI.A randomised controlled unblinded feasibility trial was conducted. Eligible participants were adult patients with a cIAI that were diagnosed ≤ 6 days prior to screening. Randomisation was to long-course (28 days) or short-course (≤10 days) antibiotic therapy. Choice of antibiotics was determined by the clinical team. Participants were followed up for 90 days. Primary outcomes were willingness of participants to be randomised and feasibility of trial procedures.In total, 172 patients were screened, 84/172 (48.8%) were eligible, and 31/84 (36.9%) were randomised. Patients were assigned to either the short-course arm (18/31, 58.0%) or the long-course arm (13/31, 41.9%). One patient in the short-course arm withdrew after randomisation. In the short-course arm, 4/17 (23.5%) were treated for a cIAI relapse vs 0/13 (0.0%) relapses in the long-course arm. Protocol violations included deviations from protocol-assigned antibiotic duration and interruptions to antibiotic therapy.This feasibility study identified opportunities to increase recruitment in a full trial. This study demonstrates completion of a randomised controlled trial to further evaluate if the optimum antibiotic duration for cIAIs is feasible.ClinicalTrials.gov Identifier: NCT03265834.

This chapter gives an overview of how society evolves as a result of industrial and economic advances and changes. The purpose is to define the social and technological infrastructure, needs, wants and demands that have to be in place if the society is to survive and flourish. It is not enough simply to provide the means of economic activity; quality of life has to be present also. It follows from this that much of business and economic development takes place in order to develop and underpin the quality of life demanded.

The purpose of this chapter is to set out clearly the relationship between established standards of conduct and behaviour, and to draw the link between conduct and behaviour and organizational and managerial performance. This link in turn is a key issue in the determination of specific corporate social values and responsibilities; and so this link is, therefore, at the core of how everyone involved conducts and discharges every obligation that they have. This is a key part of management knowledge, understanding and education; and so a key part of the drive towards the creation and agreement of a professional body of management expertise.

The relationship between business and society is under-explored; and this lack of investigation extends to the responsibilities that business has, and those it ought to have to society overall. The purpose of this chapter is to indicate the key issues that ought to be addressed, and some of the crucial points of inquiry, in deciding and determining those collective and individual responsibilities.

The changes that have impinged on society over the period since 1945, and more particularly since the 1960s, in turn impinge on the management of organisations. These changes may be summarised as: Technological, affecting all social, economic and business activities; rendering many occupations obsolete and creating new ones; and opening up new spheres of activity, bringing travel, transport, distribution, telecommunication, industry, goods and services on to a global scale Social, the changing of people’s lives, from the fundamentals of life expectancy and lifestyle choice, to the ability to buy and possess items; to travel; to be educated; to receive ever-increasing standards of health-care, personal insurance and information; to be fed; to enjoy increased standards of social security and stability, increased leisure time and choice of leisure pursuits; and all commensurate with increases in disposable income and purchasing power, and choices of purchase; Eco-political, resulting in changes in all governmental forms; the state of flux of the EC, and the adoption of super-national laws and directives, and the single market; the collapse of the communist bloc and the USSR; the fragmentation of the former Yugoslavia into its component states; the emergence of Taiwan, South Africa, Korea and Vietnam as spheres of political and economic influence, taking their place in the business sphere Expectational, in which the changes may be expressed as from stability to a state of change itself, a state of flux; the change from the expectation of working for one company or organisation, to working for many, and the realisation that the former is increasingly unlikely; change in occupation, training and profession; change in political governance, and the instruments of state; organisations change their business (e.g. Virgin, from music into air travel) and expect their staff to change with them; hospitals in the UK are (1992–95) being reconstituted as ‘business units’ and offering medical services at a price or charge, and are expecting staff and patients to go along with this; business is indeed ‘thriving on chaos’, and ‘learning to love change’, and this is increasingly expected by those who manage it.