GI Variceal Haemorrhage in Cirrhotic Patients

First Line

Co-amoxiclav 1.2g IV 8 hourly


Penicillin Allergy

Vancomycin IV as per protocol


Ciprofloxacin 400mg IV 12 hourly (consider safety issues)


Metronidazole 500mg IV 12 hourly


Treat upper or lower GI haemorrhage in cirrhotic patients

Treatment duration: 3 days in the absence of confirmed infection


Oral switch guidance

Review culture results first. If no positive microbiology to guide:

Preferred regime - Co-amoxiclav 625mg PO 8 hourly

Alternative - Co-trimoxazole 960mg PO 12 hourly AND Metronidazole 400mg 8 hourly