Variceal Haemorrhage
Antimicrobial prescribing: NHS Fife
Warning
Clinical features
- Haematemesis
- Melaena
- Hypotension / tachycardia
Infection Control
Basic universal precautions
Treatment
CO-AMOXICLAV IV 1.2g 8 hourly
If true penicillin allergy (eGFR >35)
COTRIMOXAZOLE IV 960mg 12 hourly
PLUS
METRONIDAZOLE IV 500mg 8 hourly
If true penicillin allergy and eGFR <35
CIPROFLOXACIN IV 400mg 12 hourly (review MHRA Safety Advice before prescribing)
PLUS
METRONIDAZOLE IV 500mg 8 hourly
Duration: Review at 48-72 hours; usually doesn't require longer than this