Antibiotics

Question 1

What is the most common perioperative infection?

Answer 1

SSI (Surgical site infection)

• it is the most frequent cause of hospital readmissions after surgery
• prolong admissions by 7-10 days

Question 2

5 things a drug for surgical prophylaxis to prevent SSI should have:

Answer 2

1. Prevent SSI
2. Prevent SSI related morbidity & mortality
3. Reduce the duration & cost of healthcare
4. Produce no adverse effects
5. Have no adverse consequences for the microbial flora of the patient or the hospital

Question 3

True or False: Antibiotics are anesthesias job completely?

Answer 3

True!
- Have to have: right drug, right dose age, right time, safe, shortest effective period to minimize adverse effects/resistance, & cost

Question 4

Name 6 Beta-Lactams commonly used:

Answer 4

1. Penicillins
2. Cephalosporins
3. Carbapenems
4. Monobactams
5. Oxacephems
6. Clavams

Question 5

What are the 4 non-Beta-Lactams commonly seen in the OR?

Answer 5

1. Macrolides
2. Sulfonamides
3. Quinolones
4. Aminoglycosides

Question 6

True or False: SCIP uses evidence based clinical care guidelines that have been improving infection rates to date.

Answer 6

False: There has not been a measurable improvement in infection rates to date

Question 7

What 5 things does a bundled intervention include:

Answer 7

1. Methods for circulator to remove hair
2. Rational antibiotic prophylaxis surgeons orders (CRNA’s job)
3. Avoidance of perioperative hypothermia (CRNA’s job)
4. Management of perioperative blood glucose (CRNA’s job)
5. Effective preoperative bathing & skin preparation (patient)

Question 8

What 2 antibiotics account for 15% of anesthesia related anaphylactic reactions?

Answer 8

Penicillins & cephalosporins

- Penicillin allergy is the most commonly reported drug allergy in the US

Question 9

The development of 30 day postoperative infections have been directly linked back to what?

Answer 9

Bacterial transmission events originating from the anesthesia work station

Question 10

What is the most commonly prescribed antibiotic that you as an anesthesia provider will give?

Answer 10

Ancef (Cefazolin)

Question 11

What is the Moa of Vancomycin?

Answer 11

Impairs cell wall synthesis of gram-positive bacteria

Question 12

Why do you give Vancomycin?

Answer 12

Drug of choice for MRSA

• Given for severe staphylococcal enterocolitis & anti-microbial assoc. pseudomonas enterocolitis
• This is for those who are allergic to penicillins or cephalosporins

Question 13

How should you administer Vanc? And why?

Answer 13

Recommended 10-15 mg/kg over 60 MINUTES!

• too fast it will cause a histamine release (Red Man) & cause hypotension or even cardiac arrest
• Cannot give to everyone d/t resistance

Question 14

What is likely when there are high plasma concentrations of aminoglycosides present (> 30mcg/ml)

Answer 14

Ototoxicity