Cholecystitis
Acute
- Mild cases do not require antimicrobial therapy.
Usual Pathogens
Enterobacteriaceae
Enterococcus spp
Anaerobes
| Recommended Empiric Therapy | Recommended Dose | Recommended Duration |
|---|---|---|
| Ceftriaxone | 1-2g IV daily | 7 days |
| +/- | ||
| Metronidazole IV/PO | 500mg IV/PO q12h |
Alternative
| Recommended Empiric Therapy | Recommended Dose | Recommended Duration |
|---|---|---|
| Ampicillin | 2g IV q6h | 7 days |
| + | ||
| Gentamicin | 5-7mg/kg IV q24h | |
| +/- | ||
| Metronidazole IV/PO | 500mg IV/PO q12h |
Hemodynamic instability
| Recommended Empiric Therapy | Recommended Dose | Recommended Duration |
|---|---|---|
| Piperacillin-tazobactam | 4.5g IV q8h or | 7 days |
| 3.375g IV q6h |
Severe ß-lactam allergy
| Recommended Empiric Therapy | Recommended Dose | Recommended Duration |
|---|---|---|
| [Ciprofloxacin IV/PO | 400mg IV q12h/500mg PO bid | 7 days |
| or | ||
| Gentamicin] | 5-7mg/kg IV daily | |
| +/- | ||
| Metronidazole IV/PO | 500mg IV/PO q12h |