| Dose | |
| Single-agent regimen | |
| Piperacillin-tazobactam* | 3.375 g IV every 6 hours |
| Combination regimen with metronidazole* | |
| One of the following: | |
| Cefazolin | 1 to 2 g IV every 8 hours |
| or | |
| Cefuroxime | 1.5 g IV every 8 hours |
| or | |
| Ceftriaxone | 2 g IV once daily |
| or | |
| Cefotaxime | 2 g IV every 8 hours |
| or | |
| Ciprofloxacin | 400 mg IV every 12 hours or 500 mg PO every 12 hours |
| or | |
| Levofloxacin | 750 mg IV or PO once daily |
| Plus: | |
| Metronidazole¶ | 500 mg IV or PO every 8 hours |
For empiric therapy of low-risk community-acquired intra-abdominal infections, we cover streptococci, Enterobacteriaceae, and anaerobes. Low-risk community-acquired intra-abdominal infections are those that are of mild to moderate severity (including perforated appendix or appendiceal abscess) in the absence of risk factors for antibiotic resistance or treatment failure. Such risk factors include recent travel to areas of the world with high rates of antibiotics-resistant organisms, known colonization with such organisms, advanced age, immunocompromising conditions, or other major medical comorbidities. Refer to other UpToDate content on the antimicrobial treatment of intra-abdominal infections for further discussion of these risk factors.
The antibiotic doses listed are for adult patients with normal renal function. The duration of antibiotic therapy depends on the specific infection and whether the presumptive source of infection has been controlled; refer to other UpToDate content for details.IV: intravenously; PO: orally.
* When piperacillin-tazobactam or one of the combination regimens in the table cannot be used, ertapenem (1 g IV once daily) is a reasonable alternative.
¶ For most uncomplicated biliary infections of mild to moderate severity, the addition of metronidazole is not necessary.