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Perirectal abscess Possible therapeutic alternatives
Perirectal abscess


Common pathogens
Mild / Outpatient treatment:

Levofloxacin 750mg orally once daily OR
Moxifloxacin 400mg po qd  OR
Ciprofloxacin 750mg twice daily OR
Bactrim DS orally twice daily

Metronidazole 500mg po q6h

Augmentin XR* 1000/62.5 mg 2 tablets orally twice daily

*AUGMENTIN XR is contraindicated in patients with a creatinine clearance of < 30 mL/min. and in hemodialysis patients

Hospitalized patient:

Piperacillin-tazobactam 3.375 grams IVPB q6h  OR
Ticarcillin-clavulanic acid 3.1 grams IVPB q6h OR
Cefotetan 1 to 2 grams IVPB q12h OR
Ertapenem 1 gm IV q24h

Penicillin allergic:
Ciprofloxacin 400mg IVPB q12h  OR
Levofloxacin 750 mg IV q24h OR
Aztreonam 2 grams IV q6h to q8h

Metronidazole  500mg IVPB q6h


Peri-rectal abscess