Routine Practices
Diagnostic Considerations
Abdominal Imaging
CBC, and blood culture
Consider CSF culture if systemically ill
Enteric Gram negative bacilli
Enterococcus spp.
Anaerobes
Ampicillin
PLUS
Tobramycin
+/-
Metronidazole
Add for perforation, peritonitis and rapidly advancing sepsis
OR
Piperacillin+Tazobactam
In patients who fail initial treatment or have intolerance to aminoglycosides
7 days, but may extend for prolonged illness up to 14 days
