Spectrum: Local Antimicrobial Stewardship, for CHEO-OCTC

Appendicitis

Suggested Regimen

Tobramycin IV 2.5 mg/kg/dose (Max 120 mg/dose)

Repeat Dosing During Procedure

Every 8 hours

AND

MetroNIDAZOLE IV 10 mg/kg/dose (Max: 500mg/dose)

Repeat Dosing During Procedure

Every 12 hours

AND

Ampicillin IV 50 mg/kg/dose (Max: 2000mg/dose)

Repeat Dosing During Procedure

Every 6 hours

For Ig-E mediated hypersensitivity to penicillin (e.g. hypotension, bronchospasm, anaphylaxis), and clinical signs of perforation, USE CEFAZOLIN instead of ampicillin

CeFAZolin IV 30 mg/kg/dose (Max 2000 mg/dose)*

*The maximum adult IV dose for
CeFAZolin in patients ≥ 120 kg is 3 g/dose.

Repeat Dosing During Procedure

q4h

Duration of Therapy

For uncomplicated appendicitis no antimicrobial therapy is required post-operatively

For perforated or gangrenous appendicitis

without abscess, usual suggested duration of therapy for antimicrobials after surgery is 3 to 5 days