Template:Appendicitis Antibiotics: Difference between revisions
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''Coverage should extend to E. coli, Klebsiella, Proteus, and Bacteroides (an anaerobe)'' | ''Coverage should extend to [[E. coli]], [[Klebsiella]], [[Proteus]], and [[Bacteroides]] (an anaerobe)'' | ||
====Adult Simple Appendicitis==== | ====Adult Simple Appendicitis==== | ||
''Antibiotic prophylaxis should be coordinated with surgical consult'' | ''Antibiotic prophylaxis should be coordinated with surgical consult'' | ||
'''Options:''' | '''Options:''' | ||
*[[Cefoxitin]] 2g IV q6 hours OR | *[[Cefoxitin]] 2g IV q6 hours OR | ||
*[[Cefotetan]] 2g IV q12 hours OR | *[[Cefotetan]] 2g IV q12 hours OR | ||
*[[Moxifloxacin]] 400mg IV once daily | *[[Moxifloxacin]] 400mg IV once daily OR | ||
*[[Ertapenem]] 1g IV once daily | *[[Ertapenem]] 1g IV once daily | ||
====Pediatric Simple Appendicitis==== | ====Pediatric Simple Appendicitis==== | ||
'''Options:''' | |||
*[[Cefoxitin]] 40mg/kg IV q6 hours | *[[Cefoxitin]] 40mg/kg IV q6 hours | ||
*[ | *[[Cefotetan]] 40mg/kg IV q12 hours | ||
*[[Gentamicin]] 2.5mg/kg IV q8hrs + | *[[Gentamicin]] 2.5mg/kg IV q8hrs + | ||
**[[Metronidazole]] 7.5mg/kg IV 16hrs OR | **[[Metronidazole]] 7.5mg/kg IV 16hrs OR | ||
**[[Clindamycin 10mg/kg IV q8hrs | **[[Clindamycin]] 10mg/kg IV q8hrs | ||
====Complicated Appendicitis==== | |||
''Defined as perforation, abscess, or phlegmon'' | |||
'''Options:''' | '''Options:''' | ||
*[[Metronidazole]] | *[[Metronidazole]] 500 mg IV q8hrs + | ||
**[[Cefepime]] | **[[Cefepime]] 50 mg/kg IV q12hrs OR | ||
**[[Ciprofloxacin]] | **[[Ciprofloxacin]] 400 mg IV q12hrs OR | ||
**[[Levofloxacin]] | **[[Levofloxacin]] 750 mg IV q24hrs OR | ||
**[[ | **[[Aztreonam]] 30 mg/kg IV q8hrs | ||
''Cautious use should be applied to use of fluoroquinolones in complicated pediatric appendicitis due to the risk of tendon injury'' | *[[Imipenem/Cilastatin]] 25 mg/kg IV q6hrs (max 500mg) | ||
*[[Meropenem]] 20 mg/kg IV q8hrs (max 1g) | |||
*[[Piperacillin/Tazobactam]] 100 mg/kg (max 4.5g) IV q8hrs | |||
''Cautious use should be applied to use of [[fluoroquinolones]] in complicated pediatric appendicitis due to the risk of tendon injury'' | |||
Revision as of 16:08, 30 November 2018
Coverage should extend to E. coli, Klebsiella, Proteus, and Bacteroides (an anaerobe)
Adult Simple Appendicitis
Antibiotic prophylaxis should be coordinated with surgical consult
Options:
- Cefoxitin 2g IV q6 hours OR
- Cefotetan 2g IV q12 hours OR
- Moxifloxacin 400mg IV once daily OR
- Ertapenem 1g IV once daily
Pediatric Simple Appendicitis
Options:
- Cefoxitin 40mg/kg IV q6 hours
- Cefotetan 40mg/kg IV q12 hours
- Gentamicin 2.5mg/kg IV q8hrs +
- Metronidazole 7.5mg/kg IV 16hrs OR
- Clindamycin 10mg/kg IV q8hrs
Complicated Appendicitis
Defined as perforation, abscess, or phlegmon
Options:
- Metronidazole 500 mg IV q8hrs +
- Cefepime 50 mg/kg IV q12hrs OR
- Ciprofloxacin 400 mg IV q12hrs OR
- Levofloxacin 750 mg IV q24hrs OR
- Aztreonam 30 mg/kg IV q8hrs
- Imipenem/Cilastatin 25 mg/kg IV q6hrs (max 500mg)
- Meropenem 20 mg/kg IV q8hrs (max 1g)
- Piperacillin/Tazobactam 100 mg/kg (max 4.5g) IV q8hrs
Cautious use should be applied to use of fluoroquinolones in complicated pediatric appendicitis due to the risk of tendon injury