Complicated
- pancreatic abscess
- infected
- pseudocyst
- infected necrotic pancreas
- Tailor antibiotics to C&S results.
Usual Pathogens
Enterobacterales
Enterococcus spp
S. aureus
Coagulase negative Staphylococci
Anaerobes
Yeast
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Ceftriaxone | 1-2g IV daily | Based on clinical improvement. |
| + | ||
| Metronidazole | 500mg IV/PO bid | |
| Alternative |
||
| Amoxicillin-clavulanate | 1.2g IV q6h | Based on clinical improvement. |
Severe/ICU
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Piperacillin-tazobactam | 4.5g IV q8h or | Based on clinical improvement. |
| 3.375g IV q6h |
Multiple previous antibiotics/Previous ceftriaxone-resistant Gram negative organism
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Meropenem | 500mg IV q6h | Based on clinical improvement. |
| + | ||
| Vancomycin | 15mg/kg IV q12h |
Penicillin and carbapenem allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Vancomycin | 15mg/kg IV q12h | Based on clinical improvement. |
| + | ||
| Ciprofloxacin IV/PO | 400mg IV q12h/500-750mg PO bid | |
| + | ||
| Metronidazole IV/PO | 500mg IV/PO q12h |