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Guidelines
Pathogens
Antimicrobials
For mild cases without features of infection (fever, increased WBC), antimicrobials generally not necessary
Discontinue therapy within 24h after source control (e.g. cholecystectomy), unless intra-operative evidence of infection beyond the gallbladder wall
Cefazolin 1-2 gm IV q8h
OR
Ceftriaxone 1-2 gm IV q24h
ALSO CONSIDER
Add metronidazole 500mg IV q12h for biliary-enteric anastomosis
PENICILLIN ANAPHYLAXIS
Levofloxacin
750 mg IV q24h +/- metronidazole 500 mg PO/IV q12h
or
Moxifloxacin 400 mg IV q24h (monotherapy)
Day 3 Bundle