Abdominal Infections

Main Content

Bowel Injuries

Indications

  • Penetrating, blunt, or latrogenic injuries or any other spillage/contamination with enteric contents repaired or controlled within 12 hours

First line treatment

  • Cefoxitin 2g IV every 8 hours

Penicillin 

  • Metronidazole 500mg IV or PO every 8 hours; plus**
    • Ciprofloxacin 400mg IV or 500mg PO every 12 hours;
      or
    • Aztreonam 1g IV every 8 hours

Duration*

  • 24 hours after source control

Notes

*Longer treatment regimens may be needed if:

  • Lack of source control
  • Immunosuppressed patients

**Consider the following in critically ill patients:

  • IDSA guidelines recommend against fluoroquinolone use in setting of severe/high risk infection if resistance patterns of E. coli are <10-20%
  • Institution specific (UMC) sensitivity is 65%
  • A fluoroquinolone is a reasonable choice in mild to moderate community-acquired intra-abdominal infection based on sensitivities.


Disclaimer: The contents of this application are for the exclusive and specific use of University of Mississippi Medical Center faculty and trainees. Any other use is neither authorized nor sanctioned by UMMC. The information is for educational purposes only. The contents of this application are for the exclusive and specific use of UMMC faculty and trainees. Any other use is neither authorized nor sanctioned by UMMC. The information is for educational purposes only.