8. Gastrointestinal system

Origin of infection		IV treatment		Oral treatment
Severe gastroenteritis requiring hospital admission. Cause unknown*		Ciprofloxacin 200-400mg BD		Ciprofloxacin 500mg BD Treat for 3-5 days
Invasive Salmonellosis		Ciprofloxacin 200 – 400mg BD		Ciprofloxacin 250 – 500mg BD or Trimethoprim 200mg BD
Enteric Fever (Typhoid)		Ciprofloxacin 200 – 400mg BD or Chloramphenicol 50mg/kg/day in four divided doses		Ciprofloxacin 250 – 500mg BD or Chloramphenicol 50mg/kg/day in four divided doses Treat for 14 days
Severe Campylobacter Enteritis				Erymax 500mg BD or Ciprofloxacin 250 – 500mg BD
Bacillary Dysentry		Antibiotic not usually recommended in Shigella sonnei infections Severe infections – treat as for invasive salmonellosis
Biliary Tract Infection (cholecystitis / cholangitis)		Tazocin 4.5g TDS plus Gentamicin (See protocol for dose - levels must be monitored) or Ciprofloxacin 200 – 400mg BD Note: prolonged IV therapy may be necessary due to compromised poral absorption		Ciprofloxacin 500mg BD plus / minus Metronidazole 400mg TDS Treat for 7-10 days
Infective pancreatitis		Tazocin 4.5g TDS plus Gentamicin (if severe / no improvement) (See protocol for dose - levels must be monitored) or Ciprofloxacin 200 – 400mg bd plus / minus metronidazole 400mg TDS		Ciprofloxacin 500mg BD plus / minus Metronidazole 400mg TDS
Peritonitis		Tazocin 4.5g TDS plus Gentamicin (See protocol for dose. Monitor levels) or Ciprofloxacin 200-400mg BD plus Metronidazole 500mg TDS		Ciprofloxacin 500mg BD plus Metronidazole 400mg TDS Once clinical improvement occurs oral antibiotics can be used for a further 7-10 days
Diverticulitis		Cefuroxime 750mg - 1.5g TDS plus Metronidazole 500mg TDS		Co-amoxiclav 625mg TDS
Antibiotic Associated Colitis				Metronidazole 400mg tds for ten days See protocol   Consult microbiology if patient relapses

 * NOTE: Please be aware of other causes of diarrhoea such as Clostridium difficile or E. coli 0157, especially if recent antibiotic exposure