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31 Cards in this Set
- Front
- Back
Major pathogens associated with surgical infections
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1)staph aureus
2)CNS 3)enterococcus 4)ecoli 5)pseudomonas |
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Antibiotic prophylaxis is indecated when...
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1)surgical procedure is associated w/ high risk of infection
2)morbidity or mortaility of a surgical side infection is high |
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When is antibiotic prophylaxis not indicated?
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contaminated or dirty operations
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When should antibiotics be administered for surgical prophylaxis?
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0-1 hr prior to 1st incision (2 hr for vancomycin)
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When should redosing by considered?
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i. surgery last >4 hours
ii. major blood loss occurs iii. short t1/2 of drug used |
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How many t1/2 lives before redosing?
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at 2 half-lives of the drug when surgery is still underway
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When should antibiotic prophylaxis be discontinued?
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within 24 hrs of procedure (preferably right after procedure)
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Gastroduodenal surgery bacteriology
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i. enteric gram - bacilli
ii. gram + cocci iii. oral anaerobes |
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Gastroduadenal surgery antibiotic prophylaxis
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cefazolin 1g IV x1 at induction
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Hepatobiliary surgery bacteriology
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i. enteric gram - bacilli
ii. enterococci iii. clostridia |
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Hepatobiliary surgery antibiotic prophylaxis
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cefazolin 1g IV x1 at induction
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Colorectal surgery bacteriology
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i. enteric gram - bacilli
ii. enterococci iii. anaerobes |
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Colorectal surgery antibiotic prophylaxis
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1. 1g Neomycin PO + 1g Erythromcyin at 1PM, 2PM, and 11PM 1 day preop
IF UNABLE TO TAKE PO: 2) IV cefoxitin, cefotetan, OR cefazolin 1-2g x1 + metronidazole 0.5-1g x1 |
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Appendectomy bacteriology
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i. enteric gram - bacilli
ii. enterococci iii. anaerobes |
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Appendectomy antibiotic prophylaxis
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Cefoxitin, cefotetan, OR cefazolin 1-2g x1 + metronidazole 0.5-1g x1
Redose if procedure >3 hours |
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Urologic bacteriology
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i. enteric gram - bacilli
ii. enterococcus |
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Urologic antibitoic prophylaxis
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1. cefazolin 1g IV x1
2. TMP/SMX 160/800mg PO x1 2 hrs prior to surgery not recommended if urine is sterile |
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Cesarean section bacteriology
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i. enteric gram - bacilli
ii. GBS iii. enterococci iv. anaerobes (rare) |
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Cesarean section antibiotic prophylaxis
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cefazolin 2g IV x1 after the cord is clamped
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Hysterectomy bacteriology
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i. enteric gram - bacilli
ii. anaerobes iii. GBS iv. enterococci |
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Hysterectomy antibiotic prophylaxis
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1. vaginal: cefazolin 1g x1
2. abdominal: cefazolin or cefotetan 1g x1 |
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Head and Neck surgery bacteriology
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i. staph aureus
ii. strep iii. oral anaerobes |
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Head and Neck surgery antibiotic prophylaxis
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cefazolin 2g IV x1
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Cardiothracic surgery bacteriology
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i. staph aureus
ii. staph epidermidis iii. corynebacterium iv. enteric gram – bacilli |
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Cardiotharcic surgery antibiotic prophylaxis
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cefazolin 1g IV x1
if hx of MRSA: Vanco |
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Vascular surgery bacteriology
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i. staph aureus
ii. staph epidermidis iii. enteric gram – bacilli |
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Vascular surgery antibiotic prophylaxis
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cefazolin 1g at induction then q8h x 2doses
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Orthopedic surgery bacteriology\
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i. staph aureus
ii. staph epidermidis |
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Orthopedic antibiotic prophylaxis
1. clean 2. joint replacement 3. hip fracture |
1. none
2. cefazolin 1g IV x 1 preop q8h x 2doses 3. cefazolin 1g IV x 1 preop then q8h x 2doses |
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Neurosurgery bacteriology
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i. staph aureus
ii. staph epidermidis |
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Neurosurgery antibiotic prophylaxis
CSF shunt; craniotomy |
CSF shunt: cefazolin or ceftriaxone 1g x1
Craniotomy: cefazolin or cefotaxime |