Acute cholecystitis medical therapy: Difference between revisions

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* 2 '''Stage 2 - Moderate (grade II) and severe (grade III) acute cholecystitis'''
* 2 '''Stage 2 - Moderate (grade II) and severe (grade III) acute cholecystitis'''
** 2.1 '''Adult'''
** 2.1 '''Adult'''
***Parenteral regimen
*** Preferred regimen (1): [[Piperacillin/tazobactam]] 3.375 or 4.5 g IV q6h
*** Preferred regimen (1): [[Piperacillin/tazobactam]] 3.375 or 4.5 g IV q6h
*** Alternative regimen (1): [[Ampicillin/sulbactam]] 3 g IV q6h  
*** Alternative regimen (1): [[Ampicillin/sulbactam]] 3 g IV q6h  

Revision as of 16:55, 8 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Acute cholecystitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Acute cholecystitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Guidelines for Management

Case Studies

Case #1

Acute cholecystitis medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Acute cholecystitis medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Acute cholecystitis medical therapy

CDC on Acute cholecystitis medical therapy

Acute cholecystitis medical therapy in the news

Blogs on Acute cholecystitis medical therapy

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for Acute cholecystitis medical therapy

Overview

The mainstay of treatment for acute cholecystitis is surgery. Pharmacologic medical therapy is recommended for patients with acute cholecystitis in which surgery is delayed.

Medical Therapy

  • Pharmacologic medical therapy is recommended for patients with acute cholecystitis in which surgery is delayed and in complicated cases.
  • Antibiotics are not indicated for the conservative management of acute calculous cholecystitis or in patients scheduled for cholecystectomy.[1]
  • Empiric pharmacologic medical therapies for acute cholecystitis include either amoxicillin/clavulanic acid, cefoxitin, cefotaxime, or ceftriaxone with metronidazole, and ciprofloxacin or levofloxacin with metronidazole.
  • Empirically administered antimicrobial drugs should be changed for more appropriate agents, according to the identified causative microorganisms and their susceptibility testing results.

Disease Name

  • 1 Stage 1 - Mild (grade I) acute cholecystitis
    • 1.1 Adult
      • Preferred regimen (1): Ampicillin/sulbactam 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
      • Preferred regimen (2): Ciprofloxacin 500 mg PO q8h for 14-21 days
      • Preferred regimen (3): Levofloxacin 500 mg q12h for 14-21 days
      • Alternative regimen (1): Cefazolin 500 mg PO q6h for 7–10 days
      • Alternative regimen (2): Cefotiam 500 mg PO q12h for 14–21 days
      • Alternative regimen (3): drug name 500 mg PO q6h for 14–21 days
  • 2 Stage 2 - Moderate (grade II) and severe (grade III) acute cholecystitis

References

  1. "Systematic review of antibiotic treatment for acute calculous cholecystitis - van Dijk - 2016 - BJS - Wiley Online Library".

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