Aggressive sepsis resuscitation
Coverage is targeted at E. coli, Enterococcus, Bacteroides, and Clostridium (anerobic)
Metronidazole 500mg IV q8hrs PLUS Ciprofloxacin 400mg IV q12hrs
Piperacillin/Tazobactam 4.5g IV q8hrs
Imipenem/Cilastin 500mg IV q6hrs
Doripenem 500mg IV q8hrs
Meropenem 1g IV q8hrs
expand coverage for MRSA if severe sepsis or septic shock
Vancomycin 15-20mg/kg PLUS any of the following options
Vancomycin 15-20mg/kg PLUS any of the following options
Involvement with GI for ERCP and general surgery for acute cholecystectomy is necessary for source control and biliary decompression
Ascending cholangitis
Gallbladder disease
Choledocholithiasis
Symptomatic cholelithiasis 
Acalculous cholecystitis
Acute calculous cholecystitis
Acute cholecystitis
Chronic pancreatitis