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Antimicrobials
Urgent surgical/gastroenterology consult for definitive therapy required (e.g. ERCP or percutaneous drainage to relieve obstruction)
Community acquired cholangitis, uncomplicated
Community acquired cholangitis with severe sepsis or immunocompromised
Severe sepsis includes all of the following:
SIRS criteria (Two of HR>90, tachypnea, Temp >38 or <36, WBC >12 or <4),
Suspected/confirmed infection,
At least one new organ dysfunction (hypotension, elevated lactate, AKI, acute lung injury, DIC, neurologic or hepatic)
Health Care Associated, including stent or other foreign body in biliary tract
Health Care Associated A non pre-existent infection occurring ≥ 48 hours after hospital admission and/or within 90 days of discharge from a health care facility or regular outpatient visits (eg. dialysis or chemotherapy).
Hepatic Transplant patient
Patient colonized with or has history of VRE infection