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31 Cards in this Set

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Major pathogens associated with surgical infections
1)staph aureus
2)CNS
3)enterococcus
4)ecoli
5)pseudomonas
Antibiotic prophylaxis is indecated when...
1)surgical procedure is associated w/ high risk of infection

2)morbidity or mortaility of a surgical side infection is high
When is antibiotic prophylaxis not indicated?
contaminated or dirty operations
When should antibiotics be administered for surgical prophylaxis?
0-1 hr prior to 1st incision (2 hr for vancomycin)
When should redosing by considered?
i. surgery last >4 hours
ii. major blood loss occurs
iii. short t1/2 of drug used
How many t1/2 lives before redosing?
at 2 half-lives of the drug when surgery is still underway
When should antibiotic prophylaxis be discontinued?
within 24 hrs of procedure (preferably right after procedure)
Gastroduodenal surgery bacteriology
i. enteric gram - bacilli
ii. gram + cocci
iii. oral anaerobes
Gastroduadenal surgery antibiotic prophylaxis
cefazolin 1g IV x1 at induction
Hepatobiliary surgery bacteriology
i. enteric gram - bacilli
ii. enterococci
iii. clostridia
Hepatobiliary surgery antibiotic prophylaxis
cefazolin 1g IV x1 at induction
Colorectal surgery bacteriology
i. enteric gram - bacilli
ii. enterococci
iii. anaerobes
Colorectal surgery antibiotic prophylaxis
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
Appendectomy bacteriology
i. enteric gram - bacilli
ii. enterococci
iii. anaerobes
Appendectomy antibiotic prophylaxis
Cefoxitin, cefotetan, OR cefazolin 1-2g x1 + metronidazole 0.5-1g x1

Redose if procedure >3 hours
Urologic bacteriology
i. enteric gram - bacilli
ii. enterococcus
Urologic antibitoic prophylaxis
1. cefazolin 1g IV x1
2. TMP/SMX 160/800mg PO x1 2 hrs prior to surgery

not recommended if urine is sterile
Cesarean section bacteriology
i. enteric gram - bacilli
ii. GBS
iii. enterococci
iv. anaerobes (rare)
Cesarean section antibiotic prophylaxis
cefazolin 2g IV x1 after the cord is clamped
Hysterectomy bacteriology
i. enteric gram - bacilli
ii. anaerobes
iii. GBS
iv. enterococci
Hysterectomy antibiotic prophylaxis
1. vaginal: cefazolin 1g x1
2. abdominal: cefazolin or cefotetan 1g x1
Head and Neck surgery bacteriology
i. staph aureus
ii. strep
iii. oral anaerobes
Head and Neck surgery antibiotic prophylaxis
cefazolin 2g IV x1
Cardiothracic surgery bacteriology
i. staph aureus
ii. staph epidermidis
iii. corynebacterium
iv. enteric gram – bacilli
Cardiotharcic surgery antibiotic prophylaxis
cefazolin 1g IV x1

if hx of MRSA: Vanco
Vascular surgery bacteriology
i. staph aureus
ii. staph epidermidis
iii. enteric gram – bacilli
Vascular surgery antibiotic prophylaxis
cefazolin 1g at induction then q8h x 2doses
Orthopedic surgery bacteriology\
i. staph aureus
ii. staph epidermidis
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
Neurosurgery bacteriology
i. staph aureus
ii. staph epidermidis
Neurosurgery antibiotic prophylaxis

CSF shunt; craniotomy
CSF shunt: cefazolin or ceftriaxone 1g x1

Craniotomy: cefazolin or cefotaxime