Adult
Intra-Abdominal Infection
- Community-acquired or early hospital acquired including:
- Cholecystitis/ascending cholangitis
- Diverticulitis
- Gangrenous/perforated appendicitis
- Penetrating abdominal trauma
- Post-op peritonitis
- For cases with foreign body or immunosuppression or perforated GI tract or complex cases, discuss with Micro/ID
- For intra-abdominal sepsis see sepsis unknown origin guideline
Treat for 3-7 days (review iv daily). Typically 3-4 days after adequate source control are sufficient for most indications.
Preferred
co-amoxiclav 1.2g iv tds
Oral switch: co-amoxiclav 625mg po tds
If adequate source control is not feasible or delayed, or anaerobic organism isolated: ADD metronidazole 400mg po tds (or 500mg iv tds only if NBM)
Alternative
For penicillin allergy (non-severe or severe) OR MRSA positive:
co-trimoxazole 960mg po bd (iv only if NBM)
If adequate source control is not feasible or delayed, or anaerobic organism isolated: ADD metronidazole 400mg po tds (or 500mg iv tds)