Guidelines
Ascending Cholangitis

Ascending Cholangitis

Microbiology

Consults

GI and/or relevant subspecialty team(s) if required

Clinical Considerations

Before starting antimicrobial therapy, take blood/urine/CSF and/or other relevant samples for culture wherever possible.

Consider the need for dose adjustments (e.g. renal impairment) and age-related contraindications for antimicrobials.

First Choice

Cefotaxime may be interchanged with ceftriaxone for children over 30 days old and not on calcium-containing parenteral products (e.g. TPN)

PLUS

+/-

Consider adding for Enterococcus coverage in patients with particular risk factors (see below)

Penicillin Allergy

Cefotaxime may be interchanged with ceftriaxone for children over 30 days old and not on calcium-containing parenteral products (e.g. TPN).

PLUS

+/-

Consider adding for Enterococcus coverage in patients with particular risk factors (see below)

Review Daily

Adjust treatment according to microbiologic results as soon as they become available.

Additional Information

  • Prior endoscopic sphincterectomy
  • Cholecystectomy
  • Biliary stent placement
  • ICU admission