Antibiotic guide for Empirical Treatment of Sepsis:

Abdominal/biliary infections:

eg: perforation of abdominal / gynaecological viscus which is usually polymicrobial.

Before proceeding, please read advice regarding the national rise in multi-resistant Gram negative organisms  (Click here)

• Co-amoxiclav IV 1.2g tds
• If rash with penicllins Cefuroxime IV 1.5g tds (not to be used in serious penicillin allergy e.g urticarial rash within first 72 hours, anaphylaxis or angioedema plus Metronidazole IV 500mg tds
• If the patient has severe sepsis or blood pressure fails to respond to initial fluid bolus: also give a single dose of Gentamicin IV 5mg/kg (to a maximum 500mg) -reduce dose in renal impairment).

OR if risk of multi resistant gram negative bacilli (MDRGNB)

• Meropenem IV 1g tds (review antibitotics with microbiology within 48 hours) Not to be used in serious pencillin allergy, e.g. anaphylaxis, contact microbiology for further advice.
• If the patient has severe sepsis or blood pressure fails to respond to initial fluid bolus: also give a single dose of Gentamicin IV 5mg/kg (to a maximum 500mg) -reduce dose in renal impairment).

Click here for full guideline.

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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