GI Variceal Haemorrhage in Cirrhotic Patients

First Line

Therapy

Co-amoxiclav 1.2g IV 8 hourly

 

Penicillin Allergy

Therapy

Vancomycin IV as per protocol

AND

Ciprofloxacin 400mg IV 12 hourly (consider safety issues)

AND

Metronidazole 500mg IV 12 hourly

Notes

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