Acute cholecystitis medical therapy

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

Acute cholecystitis Microchapters

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Acute cholecystitis medical therapy in the news

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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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