Upper GI Infection, Peritonitis and Large Bowel Sepsis

First Line

 Gentamicin IV as per protocol AND Amoxicillin 1g IV 8hrly AND Metronidazole 500mg IV 8hrly

Penicillin Allergic

Vancomycin IV as per protocol AND Gentamicin IV as per protocol AND Metronidazole 500mg IV 8hrly

If AKI or renal impairment replace Gentamicin with Ciprofloxacin 500mg PO bd (or 400mg IV 12 hrly if NBM)

 

 

Notes

Infected biliary / gastric surgery/ cholecystitis / upper GIT pre - and post-surgery / peritonitis / large bowel sepsis

DO NOT omit Gentamicin from regime unless adding alternative Gram negative bacterial cover.

  • Review use of gentamicin at 3 days with microbiology results and clinical response
  • In treatment failure or for rationalisation of therapy then discuss with senior clinician +/- microbiology