Cephalosporins or extended-spectrum penicillins are commonly used (eg, cephalexin, 0.5 g orally four times daily for 7–10 days; see Table 35–6). Trimethoprim-sulfamethoxazole (two double-strength tablets orally twice daily for 7–10 days) should be considered when there is concern that the pathogen is MRSA (see Tables 35–5 and 35–6). Vancomycin, 15 mg/kg intravenously every 12 hours, is used for patients with signs of a systemic inflammatory response.

Furthermore, drugs targeting the gut-liver axis (e.g. intregrin blockers such as vedolizumab, antibiotics) appear promising, based on the close link of PSC to inflammatory bowel disease and the emerging relevance of the gut microbiome for the development of PSC.