This document discusses antibiotic prophylaxis, which is the use of antibiotics prior to surgery to prevent infections. It describes the different wound classes based on contamination and when prophylaxis is generally required. The key aspects of administering prophylaxis are covered, including choosing an antibiotic based on the expected pathogens and resistance patterns, timing administration within 60 minutes before surgery, using a single dose with a long half-life, and typically administering intravenously. Common antibiotics used for different surgical sites are listed. The risks of prophylaxis include allergies, diarrhea, and antibiotic resistance.
This document discusses antibiotic prophylaxis, which is the use of antibiotics prior to surgery to prevent infections. It describes the different wound classes based on contamination and when prophylaxis is generally required. The key aspects of administering prophylaxis are covered, including choosing an antibiotic based on the expected pathogens and resistance patterns, timing administration within 60 minutes before surgery, using a single dose with a long half-life, and typically administering intravenously. Common antibiotics used for different surgical sites are listed. The risks of prophylaxis include allergies, diarrhea, and antibiotic resistance.
This document discusses antibiotic prophylaxis, which is the use of antibiotics prior to surgery to prevent infections. It describes the different wound classes based on contamination and when prophylaxis is generally required. The key aspects of administering prophylaxis are covered, including choosing an antibiotic based on the expected pathogens and resistance patterns, timing administration within 60 minutes before surgery, using a single dose with a long half-life, and typically administering intravenously. Common antibiotics used for different surgical sites are listed. The risks of prophylaxis include allergies, diarrhea, and antibiotic resistance.
This document discusses antibiotic prophylaxis, which is the use of antibiotics prior to surgery to prevent infections. It describes the different wound classes based on contamination and when prophylaxis is generally required. The key aspects of administering prophylaxis are covered, including choosing an antibiotic based on the expected pathogens and resistance patterns, timing administration within 60 minutes before surgery, using a single dose with a long half-life, and typically administering intravenously. Common antibiotics used for different surgical sites are listed. The risks of prophylaxis include allergies, diarrhea, and antibiotic resistance.
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Antibiotic Prophylaxis
Francis Neil C. Caranay
Antibiotic Prophylaxis Antimicrobial therapy to prevent infection Given to patients prior to a surgical procedure Indications Class 1 – Clean wounds with implants Class 2 – Clean contaminated wounds Class 3 – Contaminated wounds Class 4 – Dirty wounds Wound Class and Representative Procedures Wound Class Examples of Cases Class I (Clean) Hernia repair, breast biopsy Class II (Clean-contaminated) Cholecystectomy, elective GI surgery, Colorectal surgery Class III (Contaminated) Penetrating abdominal trauma, large tissue injury, enterotomy during bowel obstruction
Class IV (Dirty) Perforated diverticulitis, necrotizing
*Prophylactic antibiotics NOT generally required for Class I
Administration of Antibiotic Prophylaxis Choice of antibiotic ◦ Antibiotic must cover expected pathogens ◦ Must take into account local resistance patterns ◦ First choice should be narrow spectrum and less expensive antibiotics Timing of administration ◦ IV prophylactic antibiotics should be given within 60 minutes before skin is incised ◦ IV Vancomycin given starting 90 minutes prior to skin incision ◦ For Caesarean section, antibiotic is given pre- incision or after cord clamping Duration of prophylaxis ◦ Single dose of antibiotic with long enough half-life lasting throughout the operation ◦ Up to 24 hours for arthroplasty ◦ Additional dosage for cardiac surgery longer than 4 hours Route of administration ◦ Antibiotics should be administered intravenously ◦ Other routes: Topical Intranasal Impregnated cement Intracameral Antibiotic agents used Penicillins Cephalosporins Ampicillin – sulbactam Vancomycin Prophylactic use of Antibiotics Site Antibiotic Alternative Cardiovascular Surgery Cefazolin, cefuroxime Vancomycin Gastroduodenal area Cefazolin, cefoteta, cefoxitin, Fluoroquinolone ampicillin-sulbactam Biliary tract with active Ampicillin-sulbactam, Fluoroquinolone plus infection ticarcillin-clavulanate, clindamycin or piperacillin-tazobactam metronidazole Colorectal surgery, Cefazolin plus metronidazole, Gentamicin or obstructed ertapenem, ticarcillin,- fluoroquinolone plus small bowel clavulanate, piperacillin- clindamycin or tazobactam metronidazole