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
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