Page 81 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

Infected pancreatic necrosis Imipenem/cilastatin 500mg IV q6h Ciprofloxacin 400mg IV q12h No need for antibiotic in:
▪ Mild to moderate
OR PLUS pancreatitis
Meropenem 1gm IV q8h Metronidazole 500 mg IV q8h ▪ Severe acute pancreatitis
▪ Sterile necrosis

CT guided needle aspiration
for gram-stain & culture
should be performed

References:
1. American College of Gastroenterology guideline: Management of Acute Pancreatitis 2013

Diverticulitis Amoxicillin/clavulanate 1.2g IV q8h Piperacillin/tazobactam 4.5gm IV q6h Duration: 4-7 days, can be
longer if adequate source
OR Penicillin Allergy: control is not obtained
Ampicillin/sulbactam 3gm IV q6h Ciprofloxacin 400mg IV q12h

References:
1. IDSA Guideline for Intrabdominal infection ; Clin Infect Dis 2010:50; 133-164

Hepatosplenic candidiasis Fluconazole 400mg (6mg/kg) IV q24h Amphotericin B 0.5–0.7mg/kg IV q24h Duration of therapy is until
lesions have resolved
(usually months) and should
continue through periods of
immunosuppression

References:
1. IDSA guideline on Management of candidiasis

HPP AMG Gastrointestinal Infections 35