Template:Cholecystitis Antibiotics
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Most often isolated organisms are Escherichia coli, Klebsiella pneumonia, and anaerobes, especially Bacteroides fragilis; pathogenicity of Enterococci remains unclear and specific coverage is not routinely suggested for community-acquired infections[1]
Uncomplicated Cholecystitis
- Ertapenem 1g IV once daily OR
- Metronidazole 500mg IV q8hrs PLUS
- Ciprofloxacin 400mg IV q12 hrs OR
- Levofloxacin 750mg IV q24hrs OR
- Ceftriaxone 1g IV q24hrs
Complicated
Complicated disease such as severe sepsis or hemodynamic instability
- Vancomycin 15-20mg/kg PLUS any of the following options
Options:
- Metronidazole 500mg IV q8hrs PLUS Ciprofloxacin 400mg IV q12hrs
- Piperacillin/Tazobactam 4.5g IV q8hrs
- Imipenem/Cilastin 500mg IV q6hrs
- Doripenem 500mg IV q8hrs
- Meropenem 1g IV q8hrs
- ↑ Ansaloni L, et al. 2016 WSES guidelines on acute calculous cholecystitis. World Journal of Surgery. (2016) 11:25. DOI 10.1186/s13017-016-0082-5