ACUTE CHOLECYSTITIS AND ACUTE CHOLANGITIS

GENERAL MEASURES

Surgical drainage / cholecystectomy according to indication and/or patient’s

condition.

MEDICINE TREATMENT

Acute cholecystitis

Mild and asymptomatic cases without risk factors may not require antibiotic

treatment. If signs of infection present and/or risk factors for severe disease

present:

» Elderly patients (older than 60 years)

» Co-morbidity

» Immune compromise

Acute cholecystitis and acute cholangitis

• Ampicillin, IV, 1 g 6 hourly.

PLUS

• Gentamicin, IV, 6 mg/kg daily.

PLUS

• Metronidazole, IV, 500 mg 8 hourly.

REFERRAL

» Clinical deterioration or failure to improve.

» Fistulae or perforation.

» Need for complicated surgery.

Reference and further reading

Standard Treatment Guidelines and Essential Medicines List for South Africa 2012 Edition

See also  Upper Respiratory Track (URT)

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