Template:Appendicitis Antibiotics: Difference between revisions

Latest revision as of 12:50, 20 March 2026

Coverage should extend to E. coli, Klebsiella, Proteus, and Bacteroides (an anaerobe)

Adult Simple Appendicitis

Antibiotic prophylaxis should be coordinated with surgical consult

Options:

Cefoxitin 2g IV q6 hours OR
Cefotetan 2g IV q12 hours OR
Moxifloxacin 400mg IV once daily OR
Ertapenem 1g IV once daily

Pediatric Simple Appendicitis

Options:

Cefoxitin 40mg/kg IV q6 hours
Cefotetan 40mg/kg IV q12 hours
Gentamicin 2.5mg/kg IV q8hrs +
- Metronidazole 7.5mg/kg IV q6hrs OR
- Clindamycin 10mg/kg IV q8hrs
Ertapenem 15mg/kg IV q12h (max 1g); >13 years: 1g IV daily

Adult Complicated Appendicitis

Defined as perforation, abscess, or phlegmon

Options:

Metronidazole 500mg IV q8hrs +
- Cefepime 2g IV q12hrs OR
- Ciprofloxacin 400mg IV q12hrs OR
- Levofloxacin 750mg IV q24hrs OR
- Aztreonam 2g IV q8hrs
Imipenem/Cilastatin 500mg IV q6hrs
Meropenem 1g IV q8hrs
Piperacillin/Tazobactam 4.5g IV q8hrs

Pediatric Complicated Appendicitis

Options:

Metronidazole 7.5mg/kg IV q6hrs +
- Cefepime 50mg/kg IV q12hrs (max 2g) OR
- Aztreonam 30mg/kg IV q8hrs
Imipenem/Cilastatin 25mg/kg IV q6hrs (max 500mg)
Meropenem 20mg/kg IV q8hrs (max 1g)
Piperacillin/Tazobactam 100mg/kg IV q8hrs (max 4.5g)

Cautious use should be applied to use of fluoroquinolones in complicated pediatric appendicitis due to the risk of tendon injury

@@ Line 1: / Line 1: @@
-''Coverage should extend to E. coli, Klebsiella, Proteus, and Bacteroides (an anaerobe)''
+''Coverage should extend to [[E. coli|E. coli]], [[Klebsiella|Klebsiella]], [[Proteus|Proteus]], and [[Bacteroides|Bacteroides]] (an anaerobe)''
 ====Adult Simple Appendicitis====
 ''Antibiotic prophylaxis should be coordinated with surgical consult''
 '''Options:'''
-*[[Cefoxitin]] 2g IV q6 hours OR
+*{{AntibioticDose|disease=Appendicitis|drug=Cefoxitin|dose=2g IV q6 hours|context=Adult Simple}} OR
-*[[Cefotetan]] 2g IV q12 hours OR
+*{{AntibioticDose|disease=Appendicitis|drug=Cefotetan|dose=2g IV q12 hours|context=Adult Simple}} OR
-*[[Moxifloxacin]] 400mg IV once daily
+*{{AntibioticDose|disease=Appendicitis|drug=Moxifloxacin|dose=400mg IV once daily|context=Adult Simple}} OR
-*[[Ertapenem]] 1g IV once daily
+*{{AntibioticDose|disease=Appendicitis|drug=Ertapenem|dose=1g IV once daily|context=Adult Simple}}
 ====Pediatric Simple Appendicitis====
+'''Options:'''
+*{{AntibioticDose|disease=Appendicitis|drug=Cefoxitin|dose=40mg/kg IV q6 hours|context=Pediatric Simple|population=Pediatric}}
+*{{AntibioticDose|disease=Appendicitis|drug=Cefotetan|dose=40mg/kg IV q12 hours|context=Pediatric Simple|population=Pediatric}}
+*{{AntibioticDose|disease=Appendicitis|drug=Gentamicin|dose=2.5mg/kg IV q8hrs|context=Pediatric Simple|population=Pediatric}} +
+**{{AntibioticDose|disease=Appendicitis|drug=Metronidazole|dose=7.5mg/kg IV q6hrs|context=Pediatric Simple|population=Pediatric}} OR
+**{{AntibioticDose|disease=Appendicitis|drug=Clindamycin|dose=10mg/kg IV q8hrs|context=Pediatric Simple|population=Pediatric}}
+*{{AntibioticDose|disease=Appendicitis|drug=Ertapenem|dose=15mg/kg IV q12h (max 1g); >13 years: 1g IV daily|context=Pediatric Simple|population=Pediatric}}
+====Adult Complicated Appendicitis====
+''Defined as perforation, abscess, or phlegmon''
 '''Options:'''
-*[[Cefoxitin]] 40mg/kg IV q6 hours
+*{{AntibioticDose|disease=Appendicitis|drug=Metronidazole|dose=500mg IV q8hrs|context=Adult Complicated}} +
-*[[Cefotetan]] 40mg/kg IV q12 hours
+**{{AntibioticDose|disease=Appendicitis|drug=Cefepime|dose=2g IV q12hrs|context=Adult Complicated}} OR
-*[[Gentamicin]] 2.5mg/kg IV q8hrs +
+**{{AntibioticDose|disease=Appendicitis|drug=Ciprofloxacin|dose=400mg IV q12hrs|context=Adult Complicated}} OR
-**[[Metronidazole]] 7.5mg/kg IV 16hrs OR
+**{{AntibioticDose|disease=Appendicitis|drug=Levofloxacin|dose=750mg IV q24hrs|context=Adult Complicated}} OR
-**[[Clindamycin]] 10mg/kg IV q8hrs
+**{{AntibioticDose|disease=Appendicitis|drug=Aztreonam|dose=2g IV q8hrs|context=Adult Complicated}}
+*{{AntibioticDose|disease=Appendicitis|drug=Imipenem/Cilastatin|dose=500mg IV q6hrs|context=Adult Complicated}}
+*{{AntibioticDose|disease=Appendicitis|drug=Meropenem|dose=1g IV q8hrs|context=Adult Complicated}}
+*{{AntibioticDose|disease=Appendicitis|drug=Piperacillin/Tazobactam|dose=4.5g IV q8hrs|context=Adult Complicated}}
+====Pediatric Complicated Appendicitis====
-====Complicated Appendicitis====
-'''Defined as perforation, abscess, or phlegmon'''
 '''Options:'''
-*[[Metronidazole]] 50mg IV q8hrs +
+*{{AntibioticDose|disease=Appendicitis|drug=Metronidazole|dose=7.5mg/kg IV q6hrs|context=Pediatric Complicated|population=Pediatric}} +
-**[[Cefepime]] 50mg/kg IV q12hrs OR
+**{{AntibioticDose|disease=Appendicitis|drug=Cefepime|dose=50mg/kg IV q12hrs (max 2g)|context=Pediatric Complicated|population=Pediatric}} OR
-**[[Ciprofloxacin]] 400mg IV q12hrs OR
+**{{AntibioticDose|disease=Appendicitis|drug=Aztreonam|dose=30mg/kg IV q8hrs|context=Pediatric Complicated|population=Pediatric}}
-**[[Levofloxacin]] 750mg IV q24hrs
+*{{AntibioticDose|disease=Appendicitis|drug=Imipenem/Cilastatin|dose=25mg/kg IV q6hrs (max 500mg)|context=Pediatric Complicated|population=Pediatric}}
-**[[Aztreoname]] 30mg/kg IV q8hrs
+*{{AntibioticDose|disease=Appendicitis|drug=Meropenem|dose=20mg/kg IV q8hrs (max 1g)|context=Pediatric Complicated|population=Pediatric}}
-*[[Imipenem/Cilastatin]] 25mg/kg IV q6hrs (max 500mg)
+*{{AntibioticDose|disease=Appendicitis|drug=Piperacillin/Tazobactam|dose=100mg/kg IV q8hrs (max 4.5g)|context=Pediatric Complicated|population=Pediatric}}
-*[[Meropenem]] 20mg/kg IV q8hrs (max 1g)
-*[[Piperacillin/Tazobactam]] 100mg/kg (max 4.5g) IV q8hrs
+''Cautious use should be applied to use of [[fluoroquinolones|fluoroquinolones]] in complicated pediatric appendicitis due to the risk of tendon injury''
-''Cautious use should be applied to use of fluoroquinolones in complicated pediatric appendicitis due to the risk of tendon injury''