Template:Cholecystitis Antibiotics: Difference between revisions

Latest revision as of 13:20, 20 March 2026

Most often isolated organisms are Escherichia coli, Klebsiella pneumonia, and anaerobes, especially Bacteroides fragilis

Uncomplicated

Pathogenicity of Enterococci remains unclear and specific coverage is not routinely suggested for community-acquired infections^[1]

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 or Healthcare Associated

Examples of complication include 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/Cilastatin 500mg IV q6hrs
Doripenem 500mg IV q8hrs
Meropenem 1g IV q8hrs

Pediatric

Ceftriaxone 50-75mg/kg IV daily (max 2g) + Metronidazole 7.5mg/kg IV q8hrs (max 500mg) OR
Piperacillin/Tazobactam 80-100mg/kg IV q6-8hrs (max 4.5g) OR
Meropenem 20mg/kg IV q8hrs (max 1g)

↑ 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

[WSES_2016-1] 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

[1]

@@ Line 1: / Line 1: @@
-''Coverage is targeted at [[E. coli]], [[Enterococcus]], [[Bacteroides]], and [[Clostridium]] (anerobic)''
+''Most often isolated organisms are [[Escherichia coli]], [[Klebsiella pneumonia]], and [[anaerobes]], especially [[Bacteroides fragilis]]''
-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''
-====Uncomplicated Cholecystitis====
+====Uncomplicated====
-*[[Ertapenem]] 1g IV once daily OR
+''Pathogenicity of [[Enterococci]] remains unclear and specific coverage is not routinely suggested for community-acquired infections''<ref name="WSES 2016">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</ref>
-*[[Metronidazole]] 500mg IV q8hrs PLUS
+*{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Ertapenem|dose=1g IV once daily|context=Uncomplicated}} OR
-**[[Ciprofloxacin]] 400mg IV q12 hrs OR
+*{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Metronidazole|dose=500mg IV q8hrs|context=Uncomplicated}} PLUS
-**[[Levofloxacin]] 750mg IV q24hrs OR
+**{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Ciprofloxacin|dose=400mg IV q12 hrs|context=Uncomplicated}} OR
-**[[Ceftriaxone]] 1g IV q24hrs
+**{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Levofloxacin|dose=750mg IV q24hrs|context=Uncomplicated}} OR
+**{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Ceftriaxone|dose=1g IV q24hrs|context=Uncomplicated}}
+====Complicated or Healthcare Associated====
+''Examples of complication include severe [[sepsis]] or hemodynamic instability''
+*{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Vancomycin|dose=15-20mg/kg|context=Complicated/Healthcare Associated}} PLUS any of the following options
-====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
+*{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Metronidazole|dose=500mg IV q8hrs|context=Complicated}} PLUS {{AntibioticDose|disease=Acute calculous cholecystitis|drug=Ciprofloxacin|dose=400mg IV q12hrs|context=Complicated}}
-*[[Piperacillin/Tazobactam]] 4.5g IV q8hrs
+*{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Piperacillin/Tazobactam|dose=4.5g IV q8hrs|context=Complicated}}
-*[[Imipenem/Cilastin]] 500mg IV q6hrs
+*{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Imipenem/Cilastatin|dose=500mg IV q6hrs|context=Complicated}}
-*[[Doripenem]] 500mg IV q8hrs
+*{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Doripenem|dose=500mg IV q8hrs|context=Complicated}}
-*[[Meropenem]] 1g IV q8hrs
+*{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Meropenem|dose=1g IV q8hrs|context=Complicated}}
+====Pediatric====
+*{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Ceftriaxone|dose=50-75mg/kg IV daily (max 2g)|context=Pediatric|population=Pediatric}} + {{AntibioticDose|disease=Acute calculous cholecystitis|drug=Metronidazole|dose=7.5mg/kg IV q8hrs (max 500mg)|context=Pediatric|population=Pediatric}} '''OR'''
+*{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Piperacillin/Tazobactam|dose=80-100mg/kg IV q6-8hrs (max 4.5g)|context=Pediatric|population=Pediatric}} '''OR'''
+*{{AntibioticDose|disease=Acute calculous cholecystitis|drug=Meropenem|dose=20mg/kg IV q8hrs (max 1g)|context=Pediatric Complicated|population=Pediatric}}