Intra-Abdominal Sepsis including Bacterial Peritonitis and Hepatobiliary Sepsis

Duration

Cholecystitis/cholangitis: duration usually 7 days depending on response

Post-operative treatment of intrabdominal sepsis: duration 5 days if source control achieved.

1st line

Amoxicillin IV 1g 8 hourly

+

Metronidazole IV 500mg 8 hourly

+

Gentamicin IV (Extended Interval Dosing as per guideline. Use gentamicin calculator) Max 3 days then review.

Oral stepdown Co-amoxiclav oral 625mg 8 hourly

Penicillin or Cephalosporin allergy

Vancomycin IV (dosing as per guideline. Use vancomycin calculator)

+

Gentamicin IV (Extended Interval Dosing as per guideline. Use gentamicin calculator) Max 3 days then review.

+

Metronidazole IV 500mg 8 hourly

and discuss with Consultant Microbiologist.

Oral stepdown: discuss with Consultant Microbiologist