Biliary tree

Severity
(classification)

1st line oral/iv antibiotics

Anaphylactic penicillin allergy
(see explanatory notes)

A

Minor to moderate infection

Antibiotic therapy may not be required. Consider a period of observation. If treatment is indicated see schedule B

Not Applicable

B

Moderate to severe infection

Review doses in renal impairment

CIPROFLOXACIN 750mg po bd
If nil by mouth go to schedule C

Not Applicable

C

Severe life threatening infection

Review doses in renal impairment

TAZOCIN 4.5g iv tds

 

OR
If definite history of rash allergy but no anaphylactic penicillin allergy (see explanatory notes), then use:
MEROPENEM 1g iv tds

CIPROFLOXACIN  400mg iv bd
plus
METRONIDAZOLE 500mg iv tds

 IV to Oral Switch
(explanatory notes)

CIPROFLOXACIN 750mg po bd
plus
METRONIDAZOLE 400mg po tds

 

For a total of 7 days therapy unless lab results indicate otherwise

 

For guidance on the administration of intravenous antibiotics click here
(GHNHSFT intranet)