Antibiotic Prophylaxis

Question 1

What are criteria for needing specific prophylaxis for total joint replacement?

Answer 1

1. Have to be high risk for infection
   (total joint replacement within 2 years, immunocompromise, diabetes, inflammatory arthropathy,
   Previous joint infection)
2. Have to be having procedure with high risk for bacteremia
   (any stone manipulation, any endoscopy, anyone with tube or stent, eswl, prostate biopsy, incision into urinary tract)

Question 2

Is prophylaxis indicated for simple Cysto?

Answer 2

Only in patients with risk factors

Question 3

Is prophylaxis required for ureteral stent removal?

Answer 3

In all patients

Question 4

What is prophylaxis for a PCNL and when is it indicated?

Answer 4

All patients - 1st or 2nd Gen cephalosporin Or Clinda+Gent

Question 5

When is prophylaxis indicated for removal of urethral catheter?

Answer 5

For patients with risk factors

Question 6

What is treatment duration for chronic bacterial prostatitis which is symptomatic?

Answer 6

Abx for 4-6 weeks (Bactrim or FQN)

Question 7

All women need what test performed?

Answer 7

All need a HCG

Question 8

FDA black box warnings for fluoroquinolones?

Answer 8

Tendinitis
Tendon rupture
Mental disturbances - disorientation, agitation, nervousness
Hypoglycemia and even hypoglycemic coma

Question 9

What are the recommended anabiotic’s for patients with a total joint replacement in whom prophylaxis is indicated?

Answer 9

Either a FQN or ampicillin plus gentamicin. If they are allergic to penicillin then replace ampicillin with vancomycin.