Clinical features

  • Haematemesis
  • Melaena
  • Hypotension / tachycardia

Infection Control

Basic universal precautions

Treatment

TEMOCILLIN IV 2g 8 hourly 

PLUS

AMOXICILLIN IV 1g 8 hourly 

PLUS

METRONIDAZOLE IV 500mg 8 hourly

If true penicillin allergy (eGFR >35)

COTRIMOXAZOLE IV 960mg 12 hourly 

PLUS

METRONIDAZOLE IV 500mg 8 hourly

If true penicillin allergy and eGFR <35

CIPROFLOXACIN IV 400mg 12 hourly (review MHRA Safety Advice before prescribing)

PLUS

METRONIDAZOLE IV 500mg 8 hourly

Duration

Review at 48-72 hours; usually doesn't require longer than this