GI

Question 1

Simple appendicitis

Answer 1

Flagyl 500mg IV TID
Plus
Ceftriaxone 1g IV daily or
Levofloxacin 750mg IV daily

or
Ertapenem 1g IV daily or
Moxifloxacin 400mg IV daily

Question 2

Complicated appendicitis (perforated, abscess, gangrenous, phlegmon)

Answer 2

Zosyn 4.5g IV TID or 
Imipenem/Cilastin 500mg IV QID or
Flagyl 500mg IV TID PLUS
Cefepime 2g IV BID or
Cipro 400mg IV BID or
Levofloxacin 750 mg IV daily

Question 3

Peritonitis/Perforated Viscous/Intra-abdominal Abscess Mild to moderate disease treatment

Answer 3

Flagyl 500mg IV TID
Plus
Ceftriaxone 1g IV daily or 
Cipro 400mg IV BID or
Levofloxacin 750mg IV daily

or
Ertapenem 1g IV daily or
Moxifloxacin 400mg IV daily

Question 4

Peritonitis/Perforated Viscous/Intra-abdominal Abscess Severe or life threatening disease treatment

Answer 4

Zosyn 4.5g IV TID or 
Imipenem/Cilastin 500mg IV QID or
Meropenem 1g IV TID or 
Flagyl 500mg IV TID PLUS
Cefepime 2g IV BID or
Cipro 400mg IV BID or
Levofloxacin 750 mg IV daily or 
Aztreonam 2g IV TID AND Vanc 25-30mg/kg then 15-20 IV BID

Question 5

Mild to moderate Cholecystitis/Cholangitis

Answer 5

Ceftriaxone 1g IV daily or
Cefazolin 2g IV TID
If severe PCN allergy:
Levo 750 mg IV daily

Question 6

Severe/Life threatening Cholecystitis/Cholangitis

Answer 6

Zosyn 4.5g IV TID or
Imipenem/Cilastin 500mg IV QID or
Flagyl 500mg IV TID plus
Cefepime 2g IV TID or
Levo 750mg IV daily

If MRSA suspected add
Vanc 25-30mg/kg IV then 15-20mg/kg iV BID

Question 7

DIverticulitis Outpatient

Answer 7

Treat for 7-10 days

Augmentin 875mg PO BID or
Moxifloxacin 400mg PO daily or

Flagyl 500 TID PO Plus
Cipro 500 mg PO BID or
Levo 750mg PO daily

Question 8

Diverticulitis Inpatient mid to moderate disease

Answer 8

Ertapenem 1g IV daily or
Moxifloxacin 400mg IV daily or

Flagyl 500 TID IV Plus
Ceftriaxone 1g IV daily or
Cipro 400 mg IV BID or
Levo 750mg IV daily

Question 9

Diverticulitis Inpatient severe disease

Answer 9

Zosyn 4.5g IV TID or
Imipenem/Cilastin 500mg IV QID or
Meropenem 1g IV TID or

Vanc 15-20mg BID AND Flagyl 500mg IV TID Plus
Cefepime 2g TID IV or
Cipro 400mg IV BID or
Levo 750mg IV daily

Question 10

SBP

Answer 10

Ceftriaxone 1g IV daily or
Zosyn 4.5g IV TID or
Ertapenem 1g IV daily

If prior quinolone prophylaxis: Add vanc 15-20mg BID to one of above

Question 11

PD related Peritonitis

Answer 11

Intraperitoneal (preffered):
Vancomycin 30mg/kg IP Plus
Ceftriaxone 1g IP or 
Gentamicin .6mg/kg IP or
Imipenem/cilastin 500mg IP

IV:
Vancomycin 15-20mg/kg IV BID Plus
Cefepime 2g IV  or 
Imipenem/Cilastin 500mg IV or
Aztreonam 500mg IV