Guidelines
Community-Onset

Community-Onset

Empiric Antimicrobial Therapy

Alternative Regimen

Total bilirubin >4 mg/dL precluding ceftriaxone use or metronidazole intolerance

Duration

4-7 days after source control in localized IAI

Consider a 2-week course in patients with bloodstream infections

Please refer to PH Guidelines for Management of Gram-Negative Bloodstream Infections in Adults for further guidance

Additional Treatment Notes

Daily assessment of antimicrobial regimen is strongly encouraged: 1) Revision of empirical antimicrobial therapy based on identification of microorganism 2) Further streamlining to definitive therapy based on antimicrobial susceptibility testing results

The non-stratified use of fluoroquinolones for empirical therapy of hospitalized adults with IAI is not recommended due to increasing rates of antimicrobial resistance among E. coli and other gram-negative isolates.