Gastrointestinal and intra-abdominal infections

Gastrointestinal and intra-abdominal infections

Gastrointestinal and intra-abdominal infections

Clinical condition	Common pathogens	Empirical antimicrobial agents	Alternative antimicrobial agents	Comments
Acute gastroenteritis	Viral, enterotoxigenic & enteropathogenic E. coli	None	None	Rehydration (oral/IV) essential
Food poisoning	S. aureus, B. cereus	None	None	Rehydration (oral/IV) essential
Cholera	V. cholera	Doxycycline	Azithromycin or ciprofloxacin	Rehydration (oral/IV) essential
Bacterial dysentery	Shigella, Campylobacter, Salmonella, E. coli	Ceftriaxone	Azithromycin
Amoebic dysentery	E. histolytica	Metronidazole	Tinidazole	Add diloxanide furoate 500mg q 8h for 7-10 days
Biliary tract infections	Enterobacteriaceae	Piperacillin-tazobactam or Cefoperazone-sulbactam or ertapenem	Imipenem-cilastatin 500mg q 6h or meropenem 1g IV q 8h	Surgical or endoscopic intervention may be considered for biliary obstruction
Spontaneous bacterial peritonitis	Enterobacteriaceae	Piperacillin-tazobactam or Cefoperazone-sulbactam or ertapenem	Imipenem-cilastatin or meropenem
Secondary peritonitis, intra-abdominal abscess	Enterobacteriaceae	Piperacillin-tazobactam or Cefoperazone-sulbactam or ertapenem	Imipenem-cilastatin or meropenem	Source control is important

 

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