However, its used off-label to treat it. If you have trouble swallowing pills, ask your doctor or pharmacist about taking Augmentin liquid suspension instead. Uncomplicated diverticulitis has traditionally been treated with antibiotics with reference to the microbiology, extrapolation from trials on complicated intra-abdominal infections and clinical experience. Risk Factors In patients with uncomplicated diverticulitis who are clinically stable and able to tolerate fluids, outpatient treatment with broad-spectrum antibiotics covering anaerobes and gram-negative rods is appropriate ( Table 3Table 36). If right upper quadrant pain or elevated transaminase levels occur, evidence of a pyogenic liver abscess should be sought. Disclaimer. Best food forward: Are algae the future of sustainable nutrition? Also tell them about any vitamins, herbs, and supplements you use. lincomycin derivatives, Brand names: Examples of other drugs that may be used to treat urinary tract infection (UTI) include: Examples of other drugs that may be used to treat sinus infections include: Examples of other drugs that may be used to treat skin infections include: Examples of other drugs that may be used to treat ear infections include: Examples of other drugs that may be used to treat pneumonia include: Taking too much of this medication can increase your risk of severe side effects. Pelez N, Pera M, Courtier R, Snchez J, Gil MJ, Pars D, Grandea L. Cir Esp. doi: 10.1002/14651858.CD009277.pub2. They can be taken as a supplement in pill or powder form or can be consumed through certain foods. The other ingredient, which is called clavulanic acid, helps the amoxicillin in Augmentin work against bacteria that are normally resistant to amoxicillin when its used alone. Liquid diets, colonic rest, antibiotics, hospitalization with intravenous (IV) antibiotics and nourishment, abscess drainage, and surgery may all be recommended to treat diverticulitis. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist. Diverticulosis is an anatomic diagnosis that describes the presence of one or more diverticula. Random-effects meta-analyses were performed with the Mantel-Haenzel method. Diverticula are small, bulging pouches These include grapefruits and grapefruit juice, which can stop the body from breaking down and correctly absorbing the medication. Acute diverticulitis is a common manifestation of diverticular disease. You can take Augmentin on an empty stomach or with a meal. In 2015, 30% of all patients attending a general practice received an antibiotic prescription. Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits. Approximately 33-67% of dose is excreted unchanged in urine, and the remainder is secreted in bile and ultimately in feces as microbiologically inactive Diverticula generally are multiple. Symax SL, Data collection and analysis: sharing sensitive information, make sure youre on a federal doi: 10.7759/cureus.27159. eCollection 2022 Jul. WebOtitis media- 75 - 100 mg/kg/day given in 4 divided doses for 5 - 10 days (PI) Strep throat- 40 mg/kg/day (max 1000 mg/day) given in 2 divided doses for 10 days (IDSA) Urinary tract infection- 50 - 100 mg/kg/day (max 2000 mg/day) given in 4 divided doses for 7 - 14 days (CTE) Adults (15 years and older) thinner wall of the right colon . Serious side effects and their symptoms can include the following: Many medications, including Augmentin, can cause rash in some people. Our aim was to evaluate the safety and efficacy of an ambulatory treatment protocol in patients with uncomplicated acute diverticulitis. Because of this, NSAIDs and glucocorticoids should be used with caution in patients who have known diverticular disease. Studies performed in the 1970s suggest that the prevalence of diverticula may be as high as 60 percent in patients older than 80 years, with no clear gender predilection. Examples of side effects that might be more likely to occur or worsen with alcohol use include: Augmentin can interact with several other medications. Augmentin is approved to treat certain types of respiratory infections. dosage, interactions, side effects, For professionals: Predisposing factors for the formation of diverticula include a low-fiber diet and physical inactivity. The location varies depending on the site of the involved diverticulum. Diverticulitis can cause various types of complications. Flagyl, Cardiovascular health: Insomnia linked to greater risk of heart attack. Yes, Augmentin is an antibiotic in the class of penicillins. Its commonly used for skin infections and gum disease in animals, but may also be used for other kinds of infections. Drinking alcohol while taking Augmentin may increase your risk of certain side effects, or make your side effects worse. For the treatment of adults with gonorrhea, the dose is 3 g given as one dose. Colorectal Disease 2010 The Association of Coloproctology of Great Britain and Ireland. doi: 10.1002/14651858.CD003811.pub3. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. Antibiotic therapy aimed at anaerobes and gram-negative rods is first-line Its good for 10 days in the refrigerator. [Current treatment of bacterial vaginosis]. If either type of tablet is scored (has an indented line across it), it can be split in half. More trials are needed to obtain more precise effect estimates. as other brand or generic, max 2 g/dose; if 90 mg/kg/day regimen and wt >40 kg, give 2000 mg/125 mg ER A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Augmentin is considered a first-choice medication for this condition. Accessibility [Safety and efficiency of ambulatory treatment of acute diverticulitis]. Because of the theoretic potential to exacerbate perforation, endoscopic examination is acutely contraindicated unless inflammatory bowel disease, ischemic colitis, or carcinoma is highly suspected.17 Colonoscopy always should be performed six to eight weeks after recovery from acute diverticulitis to exclude coexisting neoplastic disease. Rashes that develop several days after you take the medication and appear as flat, red patches often indicate a different kind of rash thats not caused by an allergic reaction. Prospective randomized clinical trial of uncomplicated right-sided colonic diverticulitis: antibiotics versus no antibiotics. Secondary outcomes were recurrence, late complications, elective colonic resections, length of hospital stay, length to recovery of symptoms, adverse events and mortality. It may also be reserved for those who have had previous ear infections that were not effectively treated by amoxicillin. The mixed liquid suspension should be refrigerated. This combination makes Augmentin work against more types of bacteria than antibiotics that contain amoxicillin alone. The oral bioavailability of the amoxicillin component of Augmentin is about 74 percent to 92 percent. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Cochrane Database Syst Rev. In most cases, brushing or dental cleaning can reduce or remove the discoloration. One of the two remaining trials compared single to double compound antibiotic therapy and, due to wide confidence intervals, the estimate was imprecise and indicated an uncertain clinical effect between these two antibiotic regimens (RR 0.70; 95% CI 0.11 to 4.58; 51 participants; 1 study; low-certainty evidence). Prescribing Information, Generic name:sulfamethoxazole / trimethoprim systemic, Drug class: If you take it twice daily, spread out the doses so that theyre roughly 12 hours apart. Whether treatment is administered on an inpatient or out-patient basis is determined by the clinical status of the patient and his or her ability to tolerate oral intake. eCollection 2022 Sep. Hawkins AT, Wise PE, Chan T, Lee JT, Glyn T, Wood V, Eglinton T, Frizelle F, Khan A, Hall J, Ilyas MIM, Michailidou M, Nfonsam VN, Cowan ML, Williams J, Steele SR, Alavi K, Ellis CT, Collins D, Winter DC, Zaghiyan K, Gallo G, Carvello M, Spinelli A, Lightner AL. Augmentin use can cause a brown, gray, or yellow staining of childrens teeth. Lodi G, Azzi L, Varoni EM, Pentenero M, Del Fabbro M, Carrassi A, Sardella A, Manfredi M. Cochrane Database Syst Rev. The site is secure. Disclaimer. 2009 Feb;32(2):83-7. doi: 10.1016/j.gastrohep.2008.10.005. The most common symptom of diverticulitis is belly or abdominal pain. Careers. Bowel sounds often are decreased but may be normal early in the condition or increased in the presence of obstruction. Clavulanic acid is also a beta-lactam that can inactivate some forms of beta-lactamase. Evidence supporting outpatient treatment with oral antibiotics in patients with uncomplicated diverticulitis is limited. For this update, a comprehensive systematic literature search was conducted in Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, ClinicalTrials.gov and WHO International Clinical Trial Registry Platform on February 2021. Augmentin can be crushed. a clear liquid diet for a short time to rest the colon. Ultrasonography was found to have a specificity of 99.8 percent in one large retrospective study.16. Liquid diets, colonic rest, antibiotics, hospitalization with intravenous (IV) antibiotics and nourishment, abscess drainage, and surgery may all be recommended to treat diverticulitis. The severity of the inflammatory and infectious processes, as well as the underlying health of the patient, determines the appropriate treatment for patients with diverticulitis. Please enable it to take advantage of the complete set of features! 2005 Jan 26;94(4):91-5; quiz 96. doi: 10.1024/0369-8394.94.4.91. Diverticulosis is a common disease among Western and developed nations. The last trial compared short to long intravenous administration of antibiotics and did not report any events for our primary outcomes. The objectives of this systematic review were to determine if antibiotic treatment of uncomplicated acute diverticulitis affects the risk of complications (immediate or late) or the need for emergency surgery. The liquid suspension form of Augmentin is typically used for children. Augmentin is FDA-approved for treating UTI. Septra DS, showall, Drug class: Accessibility WebDiverticulitis. Klebsiella . Augmentin XR is usually considered a second-choice antibiotic for diverticulitis. Other commonly associated symptoms include nausea, vomiting, and constipation or diarrhea. Augmentin may not be a good choice for you if you have certain medical conditions. Colovesical fistulas are the most common variety and require surgery for treatment. Flagyl has an average rating of 6.5 out of 10 from a total of 73 ratings for the treatment of Diverticulitis. 51% of reviewers reported a positive effect, while 19% reported a negative effect. 73 ratings from 80 user reviews. Compare all 20 medications used in the treatment of Diverticulitis. Please DO NOT take Flagyl. If your dog or cat eats your prescription Augmentin, call your vet right away. However, your symptoms may not start to improve for a few days after that. Symptoms of an overdose of Augmentin can include: If you think you or your child has taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. Heart failure: Could a low sodium diet sometimes do more harm than good? WebAmoxicillin is available in doses of 250 mg, 500 mg and 1 g. These are administered in different combinations depending upon the clinical condition. Can diet help improve depression symptoms? The following information is a consensus guide. You should take Augmentin XR at the start of a meal. The following list contains some of the key side effects that may occur while taking Augmentin. It's not clear yet if we can prevent diverticulosis or diverticulitis. Each diverticulum is typically 5 to 10 mm in diameter, but at times they can exceed 20 mm. Has a potential for abuse less than those in schedules 1 and 2. Abscess: An abscess is a pocket of pus in the body caused by a bacterial infection. Clipboard, Search History, and several other advanced features are temporarily unavailable. If persistent, obstruction of the colon can be treated by a variety of endoscopic and surgical techniques. Treatment options may include antibiotics to treat any infection, pain relief medication, and dietary changes to help manage symptoms. For unknown reasons, only a small percentage of patients with diverticulosis develop symptomatic diverticular disease. MRI is an alternative for pregnant and young patients ( 1 , 2 ). If theyre more severe or dont go away, talk to your doctor or pharmacist. You might start to feel better before you finish your entire treatment. The true prevalence of diverticula is unknown, but in one large observational study5 of 9,086 consecutive patients undergoing colonoscopy for all indications, the overall prevalence of diverticulosis was 27 percent and increased with patient age. doi: 10.1002/14651858.CD012131.pub2. Randomised controlled trials (RCTs), including all types of patients with a radiologically confirmed diagnosis of left-sided uncomplicated acute diverticulitis. Similarly, no evidence supports the use of antispasmodic agents, despite the cramping and bloating often associated with symptomatic diverticular disease.3, Classically, diverticulitis is characterized by acute, constant abdominal pain most often occurring in the left lower quadrant. Available for Android and iOS devices. WebAmoxicillin with gentamicin and metronidazole Amoxicillin: 500 mg three times a day (increased to 1 g four times a day if severe infection) Gentamicin: Initially 5 to 7 mg/kg Augmentin pills should be stored at room temperature in a tightly sealed and light-resistant container. anticholinergics/antispasmodics. Augmentin and Augmentin XR are FDA-approved for treating sinus infection in adults and children. Ed-Spaz, To provide adequate coverage of gram-negative rods and anaerobic bacteria, patients with acute diverticulitis treated as outpatients should receive metronidazole (Flagyl) combined with a quinolone or with trimethoprim-sulfamethoxazole (Bactrim, Septra) or amoxicillin-clavulanate (Augmentin). NuLev, The Augmentin liquid suspension form may be used instead of the tablet for adults who have trouble swallowing pills. MeSH MNT is the registered trade mark of Healthline Media. Several surgical options are available, including resection with primary anastomosis, resection with colostomy and closure of the rectal stump, transverse colostomy and drainage, and laparoscopic colectomy. However, if you have severe diarrhea or diarrhea that doesnt go away, you should talk to your doctor. If youve never had a yeast infection before and think you might have one, see your doctor for a diagnosis and treatment. AHFS DI Monograph, Prescribing Information, Brand names: If you have an allergic reaction, you may need to be treated with a different antibiotic. A total of 5ml sulfonamides, Brand names: What is the recommended dosage of amoxicillin for a 50 lb child with strep throat? Augmentin is often reserved for children who have recently been treated with another antibiotic such as amoxicillin. Learn about side effects, interactions, warnings, dosage, Augmentin, which is used to treat certain bacterial infections, can cause side effects. 13 Sources. Symax SR Augmentin is FDA-approved to treat some types of skin infections, including cellulitis caused by certain bacteria. If you take it three times daily, spread out the doses so that theyre roughly eight hours apart. Choksey R, Stead TS, Mangal R, Amatea J, Ganti L. Cureus. This is because it works against many different types of bacteria, including some that are normally resistant to penicillin drugs. Sarah Bence, OTR/L, is an occupational therapist and freelance writer. Ambulatory treatment was initiated in 70 (73%) patients. Reconstituted Augmentin suspensions should be stored in a refrigerator and discarded after 10 days. Augmentin tablets or powder and Augmentin XR should be stored in the original container at temperatures of 77 degrees F (25 degrees C) or less. Comparator and interventions included antibiotics compared to no antibiotics, placebo, or to any other antibiotic treatment (different regimens, routes of administration, dosage or duration of treatment). Treatment options may include antibiotics to treat any infection, pain relief medication, and dietary changes to help manage symptoms. However, according to the American Academy of Pediatrics, Augmentin is not usually the first-choice antibiotic for treating ear infections in children. People with more severe disease, such as an abscess (pocket of infection) or pus that needs drainage, often need hospitalization for intravenous antibiotics. Symptomatic diverticular disease, also known as symptomatic diverticulosis, is characterized by nonspecific attacks of abdominal pain without evidence of an inflammatory process. Augmentin XR is taken twice daily. It should be used when other medications such as trimethoprim-sulfamethoxazole cannot be used. Ninety-six patients were diagnosed with uncomplicated acute diverticulitis and 26 presented at least one criterion for admission. The diagnosis of symptomatic diverticular disease is one of exclusion in patients with diverticula(Table 2). Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. showall, For professionals: Antibiotics, in the case of infection The average Augmentin XR price is about $283 for a supply of 40, 1000 mg/62.5 mg tablets. This content is owned by the AAFP. Curr Probl Surg. Has a high potential for abuse. Sarah Bence, OTR/L, is an occupational therapist and freelance writer. Disagreements were resolved by discussion or involvement of the third author. For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective). Amoxicillin is a prescription drug for short-term treatment of certain bacterial infections. Nevertheless, a high-fiber diet, fiber supplementation, or both generally are recommended and are likely to do no harm. This can cause dangerous side effects. Cipro (ciprofloxacin) is a prescription medication thats used to treat infections caused by bacteria. government site. It also happens to be the most prescribed antibiotic for uncomplicated UTIs. Adjunctive steroid therapy versus antibiotics alone for acute endophthalmitis after intraocular procedure. For severe infection, refer to severe secondary peritonitis. Patients with asymptomatic diverticulosis should eat a high-fiber diet to prevent symptomatic diverticular disease. Exceptions to this fact are highly protein-bound anaesthetics with high elimination The overall quality of evidence for outcomes was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Symax Duotab, Uncommonly, ultrasonography is used to confirm the diagnosis, primarily in patients with right-sided pain in whom other diseases (e.g., ovarian pathology) are suspected. The drug has multiple schedules. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). This antibiotic can cause such side effects as headaches, rashes, nausea and vomiting and restlessness. Intravenous antibiotics resolved the inflammatory process in both cases. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. The following information describes some of the common uses of Augmentin and Augmentin XR. WebYes, diverticulitis patients should take probiotics. These nonspecific symptoms overlap considerably with those of irritable bowel syndrome; disorders of inhibitory control of neuromuscular function may play a role in the development of both diseases.7. Brand names: Please enable it to take advantage of the complete set of features! Cellulitis is a type of skin infection. Americans, on average, eat around 14 grams each day about half of whats recommended. How to follow a diverticulitis diet On the flip side, when you have diverticulitis, the polyps are upset, inflamed and maybe even infected. Some antibiotics, including Augmentin, might decrease how well oral contraceptives (such as the birth control pill) work. Amoxicillin Dosage Medically reviewed by Drugs.com. Treatment is typically antibiotics for seven to 10 days. The diagnosis of diverticulitis is suspected most often on the basis of clinical history and physical examination. Amoxicillin is used for the treatment of acute exacerbation of bronchiectasis, but is not licensed for this indication. In such cases, ultrasonography reveals a hypoechoic or anechoic structure protruding from a segmentally thickened colonic wall. Learn about the possible side effects of taking amoxicillin. If youre breastfeeding your child, talk with your doctor before taking Augmentin. Surprisingly, misinterpretation of the influence of hypoalbuminemia on pharmacokinetics and the clinical effects of drugs seems to be a current problem, even though hypoalbuminemia has no impact on the pharmacologically active exposure. Surgery may be required for patients in whom medical management is unsuccessful.6. Epub 2009 Feb 5. The colon can become obstructed because of luminal narrowing caused by inflammation or compression by an abscess. government site. Primary outcome measures were complications and emergency surgery. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it. Approximately 85 percent of patients with diverticula are believed to remain asymptomatic. Intestinal obstruction is uncommon in diverticulitis, occurring in approximately 2 percent of patients. 2012 Aug;16(4):301-7. doi: 10.1007/s10151-012-0847-0. There are other antibiotics that are often used to treat the same conditions as Augmentin. Augmentin side effects: What you should know. In some cases, the brand-name drug and the generic version may be available in different forms and strengths. WebFlagyl effectiveness for Diverticulitis (number of people): Overall: not at all: 0 somewhat: 12 moderate: 8 high: 18 very high: 2 Long Term: not at all: 0 somewhat: 2 moderate: 2 high: 0 very high: 0 Gender of people who take Flagyl for Diverticulitis *: female: 77.5 % male: 22.5 % Recalculated strength: 125 mg/ 5 mL = 25 mg/ 1 mL 150 mg/ 25 mg = 6 mL needed. Patients were seen again at between 4 and 7 days after starting treatment to confirm symptom improvement. Has a currently accepted medical use in treatment in the United States. However, Augmentin is usually not the first-choice antibiotic for treating cellulitis. Reproduction in whole or in part without permission is prohibited. Complicated diverticulitis is defined as diverticulitis with one of the . Cirocchi R, Randolph JJ, Binda GA, Gioia S, Henry BM, Tomaszewski KA, Allegritti M, Arezzo A, Marzaioli R, Ruscelli P. Tech Coloproctol. Morphine (Duramorph) should be avoided if possible because of its propensity to increase intracolonic pressure.3,10 Patients should improve within 48 to 72 hours, at which time the diet may be advanced cautiously. The rate of emergency surgery within 30 days may be lower with no antibiotics compared to antibiotics (RR 0.47; 95% CI 0.13, 1.71; 1329 participants; 3 studies; low-certainty evidence). This could result in increased bleeding. The dry powder for the liquid suspension should also be stored at room temperature. 2019 Feb;23(2):87-100. doi: 10.1007/s10151-018-1919-6. Individual patient circumstances and local resistance patterns may alter treatment choices. But even if you do feel better, dont stop taking Augmentin. Different doses of this drug are used for animals than for humans, so dont try to treat your pet with a human prescription of Augmentin. However, be sure to take the dosage your doctor prescribes for you. 2 Repeat Investigation of the clinical features and recurrence patterns of acute right-sided colonic diverticulitis: A retrospective cohort study. The .gov means its official. Antibiotic treatment should be continued for seven to 10 days. Take Augmentin exactly according to your doctors instructions. Fiber supplementation may prevent progression to symptomatic disease or improve symptoms in patients without inflammation. Risk Factors Your doctor will determine the best dosage to suit your needs. MeSH Theyre also contraindicated in people with a history of cholestatic jaundice or liver dysfunction following treatment with Augmentin. Abuse may lead to severe psychological or physical dependence. By Sarah Bence. Last updated on Nov 30, 2022. In severe cases, surgery may be required to remove the affected portion of the intestine. antibiotics, although not all people with diverticulitis need these medicines. Amoxicillin. Some patients may complain of dysuria and frequency, reflecting what has been called sympathetic cystitis induced by bladder irritation from the adjacent inflamed colon. Right-sided pain, however, does not preclude diverticulitis because some patients have redundant sigmoid colons, and right-sided diverticula can occur, particularly in Asian populations. Thomas AR, Eyada M, Kono M, Varatharajalu K, Lu Y, Xu G, Panneerselvam K, Shatila M, Altan M, Wang J, Thompson JA, Zhang HC, Khan MA, Raju GS, Thomas AS, Wang Y. J Cancer Res Clin Oncol. Augmentin and amoxicillin are often used to treat similar types of infections. Antibiotics for uncomplicated diverticulitis. PMC Sharing this information can help you avoid potential interactions. Epub 2012 Jun 16. 2006 Dec;80(6):369-72. doi: 10.1016/s0009-739x(06)70989-7. Unable to load your collection due to an error, Unable to load your delegates due to an error. How long a medication remains good can depend on many factors, including how and where the medication is stored. Is the ketogenic diet right for autoimmune conditions? Authors of trials were contacted to obtain additional data if needed or for preliminary results of ongoing trials. Two authors performed the searches, identification and assessment of RCTs and data extraction. WebDiverticulitis is found among people who take Amoxicillin and clavulanate potassium, especially for people who are female, 60+ old, have been taking the drug fo Age of people who have Diverticulitis when taking Amoxicillin and clavulanate potassium *: 0-1: 0.0 % ; 2-9: 0.0 % ; 10-19: 0.0 % (the brand name). Effect estimates were extracted as risk ratios (RRs) with 95% confidence intervals. Cipro, See permissionsforcopyrightquestions and/or permission requests. Although it may be used off-label for treating acne, Augmentin is not usually a first choice for this purpose. In addition, Augmentin XR is contraindicated in people with severe kidney disease with a creatinine clearance of less than 30 mL/minute. 2010 The Authors. We comply with the HONcode standard for trustworthy health information. 8600 Rockville Pike There is no known interaction between Augmentin and Tylenol (acetaminophen). The white blood cell count usually is elevated with a predominance of polymorphonuclear cells. Published by John Wiley & Sons, Ltd. FOIA Diverticular hemorrhage is a possible complication of diverticulosis, and it is the most common cause of major lower gastrointestinal (GI) bleeding. There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks. Patient information: See related handout on diverticular disease, written by the authors of this article. Cipro XR, For professionals: Adult dose of amoxicillin Commonly, amoxicillin is used as a 500 mg oral or intravenous drug. This amount is divided Appropriate choices, based on expert consensus rather than randomized trials, include anaerobic coverage with metronidazole or clindamycin (Cleocin) and gram-negative coverage with an aminoglycoside, a monobactam, or a third-generation cephalosporin.6 Single-agent coverage with intravenous second-generation cephalosporins (i.e., cefoxitin [Mefoxin] or cefotetan [Cefotan]), or betalactamase inhibitor combinations such as ampicillinsulbactam (Unasyn) or ticarcillin-clavulanate (Timentin) also have been advocated.3 Meperidine (Demerol) is the opiate of choice because it has been shown to decrease intraluminal pressure.
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