Intra-Abdominal Sepsis (including appendicitis, diverticulitis, peritonitis, perianal abscess, pilonidal abscess)

Important: Therapy

• Surgical drainage is an important part of managing infected abscesses.
• Send blood for culture, 2 sets if possible, and pus from operation.
• Oral switch may not be required depending on duration of IV therapy
• Seek specialist advice if appropriate.

Notes:

Important: Therapy

Gentamicin^¥ IV (Hartford Regimen) as per guideline

Use calculator

+

IV Metronidazole 500mg 8 hourly

+

IV Amoxicillin 1g 8 hourly

 

Oral switch

Metronidazole 400mg 8 hourly

+ Doxycycline 100-200mg daily

OR 

Metronidazole 400mg 8 hourly

+ Co-trimoxazole 960mg 12 hourly

 

Notes:

^¥ If >72 hours IV therapy required replace gentamicin with temocillin IV 2g 12 hourly

Important: Therapy

IV Co-trimoxazole* 960mg 12 hourly

+

IV Metronidazole 500mg 8 hourly

 

Oral switch

Metronidazole 400mg 8 hourly

+ Doxycycline 100-200mg daily 

OR

Metronidazole 400mg 8 hourly

+ Co-trimoxazole 960mg 12 hourly

Notes:

 *If IV co-trimoxazole not available use IV ciprofloxacin 400mg twice daily and switch to oral co-trimoxazole as soon as appropriate