ANTIBIOTICS

Question 1

· Cefazolin (Ancef)

Answer 1

-Adult: 2 grams IV; 3 grams if >120 kg (Test Dose before giving rest of push)
-Pediatric: 30 mg/kg IV (max 3g/dose)
o When to give: give 30 min before incision
o Redose: Redose after 4 hours, unless single dose
o ½ Life: 2 hours
C/I: Stephen Johnson Syndrome, PCN allergy (if IgE mediated) so give vanco or clindamycin instead
o Precautions: If clean procedure, no Abx post op; redose if 1.5L blood loss; don’t continue past 24 hours of sx; prolonged effect with renal dysfunction

Question 2

· Cefoxitin

Answer 2

-Adult: 2 grams IV
-Pediatric: 40 mg/kg IV (max 2 g/dose)
o When to give: give 30 minutes before incision
o Redose: Redose after 2 hours (Don’t forget to redose)
o ½ Life: 1 hour
o C/I: Steven Johnson Syndrome, PCN allergy (if IgE mediated) so give vanco or clindamycin instead; crosses placental barrier and is 75% protein-bound
o Precautions: If clean procedure, no Abx post op; redose if 1.5L blood loss; don’t continue past 24 hours of sx; prolonged effect with renal dysfunction

Question 3

· Gentamicin

Answer 3

-Adult: 5mg/kg (IBW) 120 mg seems to always be given though?
-Pediatric: 2.5 mg/kg (IBW) (max 100 mg/dose)
o When to give: give 30 minutes before incision
o Redose: single dose
o ½ Life: 2-3 hours
o C/I: Hypersensitivity to Aminoglycosides
o Precautions: If clean procedure, no Abx post op; redose if 1.5L blood loss; don’t continue past 24 hours of sx

Question 4

· Clindamycin (Cleocin)

Answer 4

-Adult: 900 mg IV
-Pediatric: 10 mg/kg IV (max 900 mg/dose)
o When to give: give 30 minutes before incision
o Redose: Redose after 6 hours; unless single dose
o ½ Life: 2-4 hours
o C/I: Hypersensitivity to Clindamycin
o Precautions: If clean procedure, no Abx post op; redose if 1.5L blood loss; don’t continue past 24 hours of sx; prolonged minimally in liver disease