Gallbladder Empyema Medication

Updated: Nov 13, 2016
  • Author: Benjamin Pace, MD, FACS; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

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Antibiotics

Class Summary

Therapy must be comprehensive and cover all likely pathogens in the context of this clinical setting. Base selection of antibiotics on blood culture sensitivity whenever feasible. Indicated as an adjunct to decompression/resection of the gallbladder with empyema.

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Cephalosporins, 2nd Generation

Class Summary

Second-generation cephalosporins have extended coverage against anaerobes and gram-negative bacilli.

Cefuroxime (Ceftin, Zinacef)

Binds to penicillin-binding proteins and inhibits final transpeptidation step of peptidoglycan synthesis, resulting in cell-wall death; resists degradation by beta-lactamase; proper dosing and appropriate route of administration are determined by condition of patient, severity of infection, and susceptibility of microorganism.

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Penicillins, Extended-Spectrum

Class Summary

Extended-spectrum penicillins are semi-synthetic penicillin analogs used in the treatment of moderate to severe urinary, respiratory, gastrointestinal tract, skin, bone and joint infections. These agents extended activity against garm-negative bacteria and particular activity against Escherichia coli, Hemophilis  influenzae, Listeria monocytogenesis, Neisseria gonorrhoeae, Proteus mirabilis, Salmonella, Shigella, Staphylococcus aureus (non-penicillinase producing), Staphylococcus epidermidis, and Streptococcus pneumoniae.

Piperacillin/tazobactam (Zosyn)

Antipseudomonal penicillin plus beta-lactamase inhibitor; inhibits biosynthesis of cell wall mucopeptide synthesis by binding to 1 or more of the penicillin-binding proteins and is effective during active-multiplication stage.

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