Acute upper gastrointestinal haemorrhage in patients with decompensated liver disease

Important: Therapy

• Collect appropriate specimens for culture before starting treatment
• Seek specialist advice if appropriate

Notes:

Important: Therapy

If IV route required:

IV Co-trimoxazole* 960mg 12 hourly

Oral switch

Co-trimoxazole 960mg 12 hourly

Notes:

*If IV Co-trimoxazole unavailable and IV route required use IV ciprofloxacin 400mg 12 hourly. Oral switch remains co-trimoxazole.

Important: Therapy

If IV route required:

Ciprofloxacin 400mg IV 12 hourly

Oral switch

Ciprofloxacin 500mg 12 hourly

Notes:

Avoid ciprofloxacin in frail elderly patients where possible due to CDI risk. Check important safety information in BNF & give MHRA patient information leaflet to patient