GI Infections

Question 1

Which antibiotics would you use for gastroenteritis?

For how long?

Answer 1

Usually none

Question 2

Which antibiotics would you use for mild C. diff infection, i.e. when there are no severity markers present?

For how long?

Answer 2

Oral metronidazole

As long as needed, up to 5 days - then treat as severe C. diff

Question 3

Which antibiotics would you use for severe C. diff infection, i.e. with at least 1 severity marker or no response to metronidazole?

For how long?

Answer 3

Oral vancomycin

Duration: 10 days

Question 4

What are the severity markers for C. diff infection? (5)

Answer 4

Colonic dilation 6+cm
WCC: 15+
Creatinine: 1.5x baseline
Temperature: 38.5+C
Immunosuppression

Question 5

Which antibiotics would you use for intra-abdominal sepsis?

What if the patient had a true penicillin allergy?

For how long?

Answer 5

IV amoxicillin, PLUS
IV metronidazole, PLUS
IV gentamicin

In penicillin allergy: replace amoxicillin with IV vancomycin

Duration: 7 days

Question 6

Which antibiotics would you use for spontaneous bacterial peritonitis?

What if the patient had a true penicillin allergy?

For how long?

Answer 6

IV co-amoxiclav

In penicillin allergy: IV/oral ciprofloxacin, PLUS IV vancomycin

Duration: 7-10 days