Page 175 - HPP ANTIMICROBIAL GUIDELINE 2018

SURGICAL INFECTIONS
Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

Appendicitis Ampicillin/sulbactam 1.5gm IV q6h Cefoperazone 1gm IV q12h Duration of antibiotic should not
exceed 24 hours if operation
OR PLUS performed within 12 hours.
Amoxicillin/clavulanate 1.2gm IV q8h Metronidazole 1g stat then 500mg
IV q6h If operation not performed within
12 hours, consider antibiotics
5-7days

Perforated appendix / Ampicillin/sulbactam 1.5-3g gm IV q6h High risk: Duration 5-7 days
Appendicular mass Piperacillin/tazobactam 4.5gm IV
OR q6-8h for 4 days
Amoxicillin/clavulanate 1.2gm IV q8h

Low risk (CA-IAI)
Trauma related Ampicillin/sulbactam 1.5gm- 3gm IV Cefoperazone 1gm IV q12h Source control is needed to
q6h prevent on going contamination in
PLUS patient with IAI.
OR Metronidazole 1g stat then 500mg
Amoxicillin/clavulanate 1.2gm IV q8h IV q6h Duration of antibiotic should not
exceed 24 hours if operation
performed within 12 hours.

Antibiotic should not be given
High risk (HA-IAI) Piperacillin/tazobactam 4.5gm IV q6- Ertapenem 1gm IV q24h more than 4 days if adequate
Post op infection 8h for 4 days source control.
Obese
Advance age In bacteraemic patient, 7 days of
Co morbidities antibiotic therapy should be
Leucocytosis on presentation adequate.
Hypoalbuminemia

HPP AMG Surgical Infections 82