Spectrum: Local Antimicrobial Stewardship, for Island Health

Non-Operative Uncomplicated Appendicitis

Duration of Therapy

7 days

  • 3 days of IV and observation (may consider Outpatient Parenteral Antibiotic Therapy clinic), followed by

  • 4 days of oral

Recommended Empiric Regimen

Ceftriaxone 1g IV Q24H

AND

Metronidazole 500mg PO/IV Q12H

Therapy Pearls

Higher doses of Ceftriaxone add little benefit in localized IAI. 2g IV Q24h is recommended for bacteremia.

Ertapenem has also been evaluated however it is restricted to the outpatient setting.

Oral Step-Down

Amoxicillin/Clavulanate 875mg PO BID

Alternatives

Ciprofloxacin 500mg PO BID with Metronidazole 500mg PO BID

Severe Beta-Lactam Allergy

Ciprofloxacin 400mg IV OR 500mg PO Q12H

AND

Metronidazole 500mg PO/IV Q12H