Template:Appendicitis Antibiotics: Difference between revisions
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*[[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 | ||
Revision as of 20:16, 14 April 2015
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 50mg IV q8hrs +
- Cefepime 50mg/kg IV q12hrs OR
- Ciprofloxacin 400mg IV q12hrs OR
- Levofloxacin 750mg IV q24hrs
- Aztreonam 30mg/kg IV q8hrs
- Imipenem/Cilastatin 25mg/kg IV q6hrs (max 500mg)
- Meropenem 20mg/kg IV q8hrs (max 1g)
- Piperacillin/Tazobactam 100mg/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