Appendicitis, Peritonitis, Post-op appendicectomy infection, Penetrating abdominal wound

Micro Organisms

Coliforms

Anaerobes

First Line

Therapy

Amoxicillin IV + gentamicin IV + metronidazole IV for 3-7 days

Switch to co-amoxiclav PO to complete 7 day course when clinically improved

Pencillin Allergy

Therapy

Vancomycin IV + gentamicin IV + metronidazole IV for 3-7 days

Switch to oral alternative to complete 7 day course when clinically improved

Notes

Send blood for culture - if possible 2 sets and pus from operation

Please note - antibiotic surgical prophylaxis for appendicitis should be single dose at induction, unless already on treatment

Consider tetanus vaccine for penetrating abdominal wound