GI Variceal Haemorrhage in Cirrhotic Patients

Antimicrobial prescribing: NHS Forth Valley
NHS Forth Valley

First Line

Therapy

Co-amoxiclav 1.2g IV 8 hourly

 

Notes:

Penicillin Allergy

Therapy

Vancomycin IV as per protocol

AND

Ciprofloxacin 400mg IV 12 hourly (consider safety issues)

AND

Metronidazole 500mg IV 12 hourly

Notes:

Notes

Treat upper or lower GI haemorrhage in cirrhotic patients

Treatment duration: 3 days in the absence of confirmed infection

 

Oral switch guidance

Review culture results first. If no positive microbiology to guide:

Preferred regime - Co-amoxiclav 625mg PO 8 hourly

Alternative - Co-trimoxazole 960mg PO 12 hourly AND Metronidazole 400mg 8 hourly