Mild-moderate Post-Op IAI

Duration of Therapy

4-7 days

Patients with adequate source control procedure (e.g., surgery) who deffervesce, can have their antibiotics discontinued 4 days after the procedure.
Patients who do not have adequate source control or have retained hardware/mesh may require prolonged antibiotics (IV or oral) dependent on clinical and radiographic response. Consider expert consultation.

Piperacillin/Tazobactam 3.375g IV Q6H

IF MRSA suspected or wound infection ADD

Vancomycin 25mg/kg IV LOAD, then maintenance dose of 15mg/kg (See nomogram. Refer to clinical pharmacist to adjust the dose)

Therapy Pearls

Anti-pseudomonal doses of Piperacillin/Tazobactam are not necessary empirically

Lack of treatment response is most often due to inadequate source control and not antibiotic failure. Consider expert consultation.

Vancomycin can be DISCONTINUED once E. faecium and MRSA are ruled out

Culture and sensitivities permitting,

SWITCH to:

Ceftriaxone 2g IV Q24H

AND

Metronidazole 500mg PO/IV Q12H

Amoxicillin/Clavulanate 875mg PO Q12H

Otherwise culture driven

Moxifloxacin 400mg PO/IV Q24H

AND

Metronidazole 500mg PO/IV Q12H

IF MRSA suspected or wound infection ADD

Vancomycin 25mg/kg IV LOAD, then 15mg/kg as per nomogram