Sandbox Jose2: Difference between revisions

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|- bgcolor="#cccccc"
|- bgcolor="#cccccc"
! Procedure
! Procedure
! Causative etiology
! Causative etiologies
! Recommended antimicrobial prophylaxis
! Recommended antimicrobials
! Comment
! Usual adult dosage
! Comments
|-  
|-  
| colspan=5 |Cardiovascular
| colspan=5 |Cardiovascular
|-
|-
| a
|  
| b
| Staphylococcus aureus, Staphylococcus epidermidis
| c
| [[Cefazolin]]
| d
| 1-2 g IV
| The recommended dose of [[Cefazolin]] is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses. Some experts recommend an additional dose when patients are removed from bypass during open-heart surgery.
|-
|-
| 1
|  
| 2
|  
| 3
| [[Cefuroxime]]
| 4
| 1.5 g IV
| Some experts recommend an additional dose when patients are removed from bypass during open-heart surgery.
|-
|-
| colspan=4 | Gastrointestinal
|  
|
| [[Vancomycin]]
| 1 g IV
|  
|-
|-
| a
| colspan=5 | Gastrointestinal
| b
| c
| d
|-
|-
| 1
| Esophageal, gastroduodenal
| 2
| Enteric gram-negative bacilli, gram-positive cocci
| 3
| High-risk only: [[Cefazolin]]
| 4
| 1-2 g IV
| The recommended dose of [[Cefazolin]] is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
|-
| Biliary tract
| Enteric gram-negative bacilli, enterococci, clostridia
| High-risk only: [[Cefazolin]]
| 1-2 g IV
| The recommended dose of [[Cefazolin]] is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
|-
| Colorectal
| Enteric gram-negative bacilli, anaerobes, enterococci
| Oral: [[Neomycin]] {{plus}} [[Erythromycin]] bases {{or}} [[Metronidazole]]
|
| In addition to mechanical bowel preparation, 1 g of [[Neomycin]] {{plus}} 1 g of [[Erythromycin]] at 1 PM, 2 PM and 11 PM or 2 g of [[Neomycin]] {{plus}} 2 g of [[Metronidazole]] at 7 PM and 11 PM the day before an 8 AM operation.
|-
| 
| 
|  Parenteral: [[Cefoxitin]] or [[Cefotetan]]
|  1-2 g IV
| 
|-
| 
| 
|  {{or}} [[Cefazolin]]
|  1-2 g IV
|  The recommended dose of cefazolin is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
|-
| 
| 
| {{plus}} [[Metronidazole]]
| 0.5 g IV
|
|-
| 
| 
| {{or}} [[Ampicillin/Sulbactam]]
| 3 g IV
|
|-
| Appendectomy, non-perforated
| Same as for colorectal
| [[Cefoxitin]] {{or}} [[Cefotetan]]
| 1-2 g IV
| For patients allergic to penicillins and cephalosporins, [[Clindamycin]] {{or}} [[Vancomycin]] with either [[Gentamicin]], [[Ciprofloxacin]], [[Levofloxacin]] or [[Aztreonam]] is a reasonable alternative. Fluoroquinolones should not be used for prophylaxis in cesarean section.
|-
|
|
| {{or}} [[Cefazolin]]
| 1-2 g IV
|
|-
|
|
| {{plus}} [[Metronidazole]]
| 0.5 g IV
|
|-
| colspan=5 |Genitourinary
|-
| Cystoscopy alone
| Enteric gram-negative bacilli, enterococci
| High-risk only: [[Ciprofloxacin]]
| 500 mg PO {{or}} 400 mg IV
| Due to increasing resistance of E. coli to fluoroquinolones and [[Ampicillin/Sulbactam]], local sensitivity profiles should be reviewed prior to use.
|-
| 
| 
| {{or}} [[Trimethoprim-Sulfamethoxazole]]
| 1 DS tablet
|
|-
| Cystoscopy with manipulation or upper tract instrumentation
| Enteric gram-negative bacilli, enterococci
| [[Ciprofloxacin]]
| 500 mg PO {{or}} 400 mg IV
| Due to increasing resistance of E. coli to fluoroquinolones and [[Ampicillin/Sulbactam]], local sensitivity profiles should be reviewed prior to use.
|-
| 
| 
| {{or}} [[Trimethoprim-Sulfamethoxazole]]
| 1 DS tablet
|
|-
| Open or laparoscopic surgery
| Enteric gram-negative bacilli, enterococci
| [[Cefazolin]]
| 1-2 g IV
| The recommended dose of cefazolin is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
|-
| colspan=5 |Gynecologic and Obstetric
|-
| Vaginal, abdominal or laparoscopic hysterectomy
| Enteric gram-negative bacilli, anaerobes, Gp B strep, enterococci
| [[Cefazolin]] {{or}} [[Cefoxitin]] {{or}} [[Cefotetan]]
| 1-2 g IV
| The recommended dose of cefazolin is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
|-
| 
| 
| {{or}} [[Ampicillin/Sulbactam]]
| 3 g IV
| For patients allergic to penicillins and cephalosporins, [[Clindamycin]] {{or}} [[Vancomycin]] with either [[Gentamicin]], [[Ciprofloxacin]], [[Levofloxacin]] or [[Aztreonam]] is a reasonable alternative. Fluoroquinolones should not be used for prophylaxis in cesarean section. Due to increasing resistance of E. coli to fluoroquinolones and [[Ampicillin/Sulbactam]], local sensitivity profiles should be reviewed prior to use.
|-
| Cesarean section
| same as for hysterectomy
| [[Cefazolin]]
| 1-2 g IV
| The recommended dose of [[Cefazolin]] is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
|-
| Abortion, surgical
| same as for hysterectomy
| [[Doxycycline]]
| 300 mg PO
| Divided into 100 mg before the procedure and 200 mg after.
|-
| Cesarean section
| same as for hysterectomy
| [[Cefazolin]]
| 1-2 g IV
|
|-
| Cesarean section
| same as for hysterectomy
| [[Cefazolin]]
| 1-2 g IV
|
|-
| Cesarean section
| same as for hysterectomy
| [[Cefazolin]]
| 1-2 g IV
|
|-
| Cesarean section
| same as for hysterectomy
| Cefazolin
| 1-2 g IV
|
|-
| Cesarean section
| same as for hysterectomy
| Cefazolin
| 1-2 g IV
|
|-
| Cesarean section
| same as for hysterectomy
| Cefazolin
| 1-2 g IV
|
|-
| Cesarean section
| same as for hysterectomy
| Cefazolin
| 1-2 g IV
|
|-
| Cesarean section
| same as for hysterectomy
| Cefazolin
| 1-2 g IV
|
|-
| Cesarean section
| same as for hysterectomy
| Cefazolin
| 1-2 g IV
|
 
|}
|}

Revision as of 15:09, 28 July 2015

Procedure Causative etiologies Recommended antimicrobials Usual adult dosage Comments
Cardiovascular
Staphylococcus aureus, Staphylococcus epidermidis Cefazolin 1-2 g IV The recommended dose of Cefazolin is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses. Some experts recommend an additional dose when patients are removed from bypass during open-heart surgery.
Cefuroxime 1.5 g IV Some experts recommend an additional dose when patients are removed from bypass during open-heart surgery.
Vancomycin 1 g IV
Gastrointestinal
Esophageal, gastroduodenal Enteric gram-negative bacilli, gram-positive cocci High-risk only: Cefazolin 1-2 g IV The recommended dose of Cefazolin is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
Biliary tract Enteric gram-negative bacilli, enterococci, clostridia High-risk only: Cefazolin 1-2 g IV The recommended dose of Cefazolin is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
Colorectal Enteric gram-negative bacilli, anaerobes, enterococci Oral: Neomycin PLUS Erythromycin bases OR Metronidazole In addition to mechanical bowel preparation, 1 g of Neomycin PLUS 1 g of Erythromycin at 1 PM, 2 PM and 11 PM or 2 g of Neomycin PLUS 2 g of Metronidazole at 7 PM and 11 PM the day before an 8 AM operation.
Parenteral: Cefoxitin or Cefotetan 1-2 g IV
OR Cefazolin 1-2 g IV The recommended dose of cefazolin is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
PLUS Metronidazole 0.5 g IV
OR Ampicillin/Sulbactam 3 g IV
Appendectomy, non-perforated Same as for colorectal Cefoxitin OR Cefotetan 1-2 g IV For patients allergic to penicillins and cephalosporins, Clindamycin OR Vancomycin with either Gentamicin, Ciprofloxacin, Levofloxacin or Aztreonam is a reasonable alternative. Fluoroquinolones should not be used for prophylaxis in cesarean section.
OR Cefazolin 1-2 g IV
PLUS Metronidazole 0.5 g IV
Genitourinary
Cystoscopy alone Enteric gram-negative bacilli, enterococci High-risk only: Ciprofloxacin 500 mg PO OR 400 mg IV Due to increasing resistance of E. coli to fluoroquinolones and Ampicillin/Sulbactam, local sensitivity profiles should be reviewed prior to use.
OR Trimethoprim-Sulfamethoxazole 1 DS tablet
Cystoscopy with manipulation or upper tract instrumentation Enteric gram-negative bacilli, enterococci Ciprofloxacin 500 mg PO OR 400 mg IV Due to increasing resistance of E. coli to fluoroquinolones and Ampicillin/Sulbactam, local sensitivity profiles should be reviewed prior to use.
OR Trimethoprim-Sulfamethoxazole 1 DS tablet
Open or laparoscopic surgery Enteric gram-negative bacilli, enterococci Cefazolin 1-2 g IV The recommended dose of cefazolin is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
Gynecologic and Obstetric
Vaginal, abdominal or laparoscopic hysterectomy Enteric gram-negative bacilli, anaerobes, Gp B strep, enterococci Cefazolin OR Cefoxitin OR Cefotetan 1-2 g IV The recommended dose of cefazolin is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
OR Ampicillin/Sulbactam 3 g IV For patients allergic to penicillins and cephalosporins, Clindamycin OR Vancomycin with either Gentamicin, Ciprofloxacin, Levofloxacin or Aztreonam is a reasonable alternative. Fluoroquinolones should not be used for prophylaxis in cesarean section. Due to increasing resistance of E. coli to fluoroquinolones and Ampicillin/Sulbactam, local sensitivity profiles should be reviewed prior to use.
Cesarean section same as for hysterectomy Cefazolin 1-2 g IV The recommended dose of Cefazolin is 1 g for patients who weigh <80 kg and 2 g for those ~80 kg. Morbidly obese patients may need higher doses.
Abortion, surgical same as for hysterectomy Doxycycline 300 mg PO Divided into 100 mg before the procedure and 200 mg after.
Cesarean section same as for hysterectomy Cefazolin 1-2 g IV
Cesarean section same as for hysterectomy Cefazolin 1-2 g IV
Cesarean section same as for hysterectomy Cefazolin 1-2 g IV
Cesarean section same as for hysterectomy Cefazolin 1-2 g IV
Cesarean section same as for hysterectomy Cefazolin 1-2 g IV
Cesarean section same as for hysterectomy Cefazolin 1-2 g IV
Cesarean section same as for hysterectomy Cefazolin 1-2 g IV
Cesarean section same as for hysterectomy Cefazolin 1-2 g IV
Cesarean section same as for hysterectomy Cefazolin 1-2 g IV
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