Cholecystitis - Healthcare Associated

Note

Duration of therapy after source control is 4-7d guided by resolution of fever, normal WBC, and benign abdomen.

Generally, longer duration of therapy for bacteremia.

Target therapy once biliary cultures available.

If no growth or no enterococcal growth discontinue vancomycin.

Vancomycin IV loading dose followed by maintenance for target trough of 15-20 ug/mL
See dosing nomogram

If patient cannot be dosed using nomogram
contact Pharmacy.

AND

Piperacillin-tazobactam 3.375 gm IV q6h

OR

Meropenem 500 mg IV q6h or 1 gm IV q8h

OR

Imipenem-Cilastin 500 mg IV q6h

Consider ID Consultation in the immunocompromised patient