Spectrum: Local Antimicrobial Stewardship, for Bakersfield Memorial Hospital

Severe Acute Pancreatitis

Prophylactic antibiotics not routinely indicated

No Evidence of Necrosis

Antibiotics not routinely indicated

Sterile Pancreatic Necrosis

Antibiotics not routinely indicated

Infected Pancreatitis Necrosis

Meropenem 1 g IV

every 8 hr

OR

Zosyn 3.375 g IV every 8 hr

(4 hr infusion)

Infected Pancreatitis Necrosis (Penicillin Allergy)

Levofloxacin 500 mg IV every 24 hr

PLUS

Metronidazole 500 mg IV every 8 hr

Duration

For infected pancreatic necrosis, continue antibiotics for 14 days after source control is obtained.

Continuation of antibiotics beyond this time places the patient at risk for colonization or infection with resistant organisms and drug toxicity.

Antibiotics do not need to be continued until radiographic abnormalities have resolved.