Canterbury DHB

Context

Cholecystitis / Cholangitis

Pathogens

Drug Treatment

Empiric

cefuroxime

HMLSchedNZFPMLnoids

IV 1.5 g every eight hours

AND

metronidazole

HMLSchedNZFPMLnoids

PO 600 mg twice a day, or IV 500 mg every twelve hours

Severe disease (e.g. sepsis), add to the above:

gentamicin

HMLSchedNZFPMLnoids

IV 5 to 7 mg/kg ideal body weight initially. See dosing guidelines

Follow IV therapy with

amoxicillin+clavulanic acid

HMLSchedNZFPMLnoids

PO 500 mg/125 mg three times a day

OR (if mild penicillin allergy)

cefuroxime

HMLSchedNZFPMLnoids

PO 500 mg twice a day

AND

metronidazole

HMLSchedNZFPMLnoids

PO 600 mg twice a day

Severe penicillin allergy

Initiate antimicrobial therapy and consult with infectious Diseases/Clinical Microbiology.

gentamicin

HMLSchedNZFPMLnoids

IV 5 to 7 mg/kg ideal body weight initially. See dosing guidelines

AND

clindamycin

HMLSchedNZFPMLnoids

IV 600 mg every eight hours

Follow IV therapy with

trimethoprim+sulfamethoxazole

HMLSchedNZFPMLnoids

(co-trimoxazole)

PO 160 mg/800 mg twice a day

AND

metronidazole

HMLSchedNZFPMLnoids

PO 600 mg twice a day

Patients unresponsive to treatment or requiring IV therapy for more than 72 hours

Consult Infectious Diseases / Clinical Microbiology.

Information about this Canterbury DHB document (99233):

Document Owner:

Not assigned (see Who's Who)

Last Updated:

May 2019 (Gastrointestinal System)

Next Review Due:

May 2022

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document.

Topic Code: 99233