Spectrum: Local Antimicrobial Stewardship, for Billings Clinic

Acute Cholecystitis (High Risk or Severe)

Example

  • Severe physiologic disturbance

  • Advanced age

  • Immunocompromised

Initial Empiric Treatment - Single Agent

Piperacillin-Tazobactam

Initial Empiric Treatment - Combination

Cefepime

PLUS

Metronidazole

OR

Ciprofloxacin (not preferred, AMS goal reduce quinolone use)

PLUS

Metronidazole

Note

Therapy should be adjusted in accordance with culture and sensitivity results when/if they are available