Spectrum: Local Antimicrobial Stewardship, for Billings Clinic

Acute Cholangitis (Following Bilio-Enteric Anastomosis)

Initial Empiric Treatment - Single Agent

Piperacillin-Tazobactam

Initial Empiric Treatment - Combination

Cefepime

PLUS

Metronidazole

OR

Ciprofloxacin (not first line - AMS goal reduce quinolones)

PLUS

Metronidazole

Note

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