| Procedure
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Causative etiologies
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Recommended antimicrobials
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Usual adult dosage
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Comments
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| Cardiovascular
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Staphylococcus aureus, Staphylococcus epidermidis
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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.
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Cefuroxime
|
1.5 g IV
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Some experts recommend an additional dose when patients are removed from bypass during open-heart surgery.
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Vancomycin
|
1 g IV
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| Gastrointestinal
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| Esophageal, gastroduodenal
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Enteric gram-negative bacilli, gram-positive cocci
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High-risk only: Cefazolin
|
1-2 g IV
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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
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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.
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| Colorectal
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Enteric gram-negative bacilli, anaerobes, enterococci
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Oral: Neomycin PLUS Erythromycin bases OR Metronidazole
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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.
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Parenteral: Cefoxitin or Cefotetan
|
1-2 g IV
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OR Cefazolin
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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.
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PLUS Metronidazole
|
0.5 g IV
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OR Ampicillin/Sulbactam
|
3 g IV
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| 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.
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OR Cefazolin
|
1-2 g IV
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PLUS Metronidazole
|
0.5 g IV
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| Genitourinary
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| 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.
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OR Trimethoprim-Sulfamethoxazole
|
1 DS tablet
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| 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.
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OR Trimethoprim-Sulfamethoxazole
|
1 DS tablet
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| 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.
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| Gynecologic and Obstetric
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| 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.
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| Cesarean section
|
same as for hysterectomy
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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.
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| Abortion, surgical
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same as for hysterectomy
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Doxycycline
|
300 mg PO
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Divided into 100 mg before the procedure and 200 mg after.
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| Cesarean section
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same as for hysterectomy
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Cefazolin
|
1-2 g IV
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| Cesarean section
|
same as for hysterectomy
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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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