Post bowel transplant treatment
Treatment following Intestinal Transplant
Includes intestinal transplant and multi-visceral transplant
Preferred
including penicillin allergy (non-severe):
meropenem 1g iv on induction, then 500mg iv tds for 5 days
AND amphotericin B liposomal (Tillomed/Gilead/AmBisome) 3mg/kg iv daily for days 1-5
AND ganciclovir 5mg/kg iv bd for 10-14 days then convert to valganciclovir 900mg po daily (doses adjusted for renal function) UNLESS donor and recipient are both CMV IgG negative
For MRSA positive patients: ADD vancomycin iv for 5 days
Alternative
For penicillin allergy (severe) including MRSA positive patients:
Instead of meropenem, give:
ciprofloxacin* 400mg iv bd AND metronidazole 500mg iv tds AND vancomycin iv for 5 days
Other agents to be given as above.
*Ensure that the patient is given the Fluoroquinolone MHRA patient information leaflet.
Fluoroquinolones, including ciprofloxacin are associated with disabling and potentially long-lasting or irreversible side effects. See Fluoroquinolone antibiotics - severe adverse effects.