Large-Bowel Obstruction Medication

Updated: Dec 14, 2016
  • Author: Christy Hopkins, MD, MPH; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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Medication

Medication Summary

Bowel obstruction frequently necessitates surgical intervention. However, antibiotics should be started in the ED. Coverage must include gram-negative aerobic and gram-negative anaerobic organisms. The following antibiotics do not represent an all-inclusive list.

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Antibiotics

Class Summary

Antibiotic therapy must cover all likely pathogens in the context of this clinical setting.

Clindamycin (Cleocin)

Clindamycin is a lincosamide that is useful in treating serious skin and soft-tissue infections caused by most staphylococcal strains. This agent is also effective against aerobic and anaerobic streptococci, except enterococci.

Clindamycin acts by inhibiting bacterial protein synthesis via inhibition of the peptide chain initiation at the bacterial ribosome, where it preferentially binds to 50S ribosomal subunit, thereby inhibiting bacterial growth.

Metronidazole (Flagyl)

Metronidazole is an imidazole ring-based antibiotic active against various anaerobic bacteria and protozoa. This agent is used in combination with other antimicrobial agents (but used alone in Clostridium difficile enterocolitis).

Cefoxitin (Mefoxin)

Cefoxitin is a second-generation cephalosporin that is indicated for the management of infections caused by susceptible gram-positive cocci and gram-negative rods. This agent is effective against aerobic and anaerobic gram-negative organisms.

Cefotetan

Second-generation cephalosporin indicated for management of infections caused by susceptible gram-positive cocci and gram-negative rods.

Imipenem and cilastatin (Primaxin)

The combination of imipenem and cilastatin is effective against aerobic and anaerobic gram-negative organisms.

Meropenem (Merrem I.V.)

Meropenem is a bactericidal broad-spectrum carbapenem antibiotic that inhibits cell-wall synthesis. This agent is effective against most gram-positive and gram-negative bacteria

Piperacillin-tazobactam (Zosyn)

Piperacillin-tazobactam inhibits the biosynthesis of cell wall mucopeptide and is effective during the stage of active multiplication. It has antipseudomonal activity.

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