This handout is for acute appendicitis. Your care team identified this based on: right lower quadrant pain (acg 2024).
Other reasons your team may use this plan: periumbilical pain migrating to rlq (acg 2024); anorexia + nausea/vomiting (acg 2024); leukocytosis with left shift (acg 2024).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| cefazolin_metronidazole | Cefazolin 2 g IV (3 g if >120 kg) + metronidazole 500 mg IV pre-incision | IV | one-time pre-op | WSES 2020 + ACS — pre-op antibiotic prophylaxis; single dose adequate for uncomplicated |
| ceftriaxone_metronidazole | Ceftriaxone 1-2 g IV daily + metronidazole 500 mg IV q8h | IV | daily + q8h | Alternative empiric coverage for uncomplicated (ACG 2024) |
Plan: Acute appendicitis — surgical-first with antibiotic coverage (WSES 2020 + CODA + SAGES 2024)
Call 911 or go to the nearest emergency room right away if you have:
Post-op clinic 2 weeks + path review; interval appendectomy 6-8 weeks for abscess/phlegmon; colonoscopy if ≥40 (ACG 2024)
Guideline: WSES 2020 Jerusalem Guidelines + SAGES 2024 Appendicitis Guideline + CODA Trial (NEJM 2020/2021) + ACS/EAST 2025 EGS Algorithm