Spectrum: Local Antimicrobial Stewardship, for UCLA Health

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 q8h

OR

Piperacillin/Tazobactam 3.375 g IV q8h over 4h extended infusion

Infected Pancreatitis Necrosis (Penicillin Allergy)

Ciprofloxacin 400 mg IV q12h

PLUS

Metronidazole 500 mg IV q8h

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.