Antibiotics Flashcards
What are the indications for the use of antibiotics?
- Implants e.g. K-wire, silastic implant
- Prolonged surgery (> 2 hours)
- Trauma or ‘dirty’ surgery (plantar foot can be considered ‘dirty’)
- Revision surgery
- Immunocompromised patient
- Extensive dissection required (as there’ll be considerable pooled blood e.g. Winograd extensive dissection down to bone)
- Intra-operative contamination e.g. infected O/C
When are prophylactic antibiotics administered perioperatively?
Given IV 30-60 minutes prior to surgery
What is Teicoplanin?
A glycopeptide bactericidal antibiotic
Which organisms is Teicoplanin effective against?
Effective against Gram-positive bacteria, including MRSA
How does Teicoplanin work?
Interferes with bacterial cell wall synthesis by inactivating penicillin-binding proteins (PBP)
What should the prophylactic pre-op dose for Teicoplanin be?
400 mg IV for patients under 70 kg
600-800 mg IV for patients over 70 kg
What is Vancomycin?
A glycopeptide bactericidal antibiotic
Which organisms is Vancomycin effective against?
Effective against serious Gram-positive, and E. coli and Pseudomonas species
What should the prophylactic pre-op dose for Vancomycin be?
1 g IV
What is Gentamicin?
An aminoglycoside bacteriostatic antibiotic
Which organisms is Gentamicin effective against?
Active against many Gram-negative and some Gram-positive
What should the prophylactic pre-op dose for Gentamicin be?
160 mg (1.5 mg/kg) IV
How does Gentamicin work?
Inhibits bacterial protein synthesis by binding to bacterial 30S ribosome subunit
What are the side effects of Gentamicin?
Ototoxicity and nephrotoxicity
What is Flucloxacillin?
A penicillin bactericidal broad-spectrum antibiotic
Which organisms is Flucloxacillin effective against?
Effective against beta-lactamase-producing staphylococci
How does Penicillin work?
Interferes with bacterial cell wall synthesis by inactivating penicillin-binding proteins (PBP)
What should the prophylactic pre-op dose for Flucloxacillin be?
1 g IV
What is Cefuroxime?
A cephalosporin bactericidal antibiotic
Which organisms is Cefuroxime effective against?
Active against many Gram-positive and Gram-negative bacteria
How does Cefuroxime work?
Interferes with bacterial cell wall synthesis by inactivating penicillin-binding proteins (PBP)
What should the prophylactic pre-op dose for Cefuroxime be?
750 to 1,500 mg IV
What is Clindamycin?
A lincosamide bacteriostatic antibiotic
Which organisms is Clindamycin effective against?
Active against Gram-positive cocci, including MRSA, and Gram-negative
How does Clindamycin work?
Inhibits bacterial protein synthesis by binding to bacterial 50S ribosome subunit
What should the prophylactic pre-op dose for Clindamycin be?
300 to 600 mg IV
What antibiotic(s) could be used in penicillin-allergic patients?
Teicoplanin and Clindamycin
What is erythromycin?
A macrolide bacteriostatic antibiotic
How does erythromycin work?
Inhibits bacterial protein synthesis by binding to bacterial 50S ribosome subunit
What is Ciprofloxacin?
A fluoroquinolone antibiotic
How does Ciprofloxacin work?
Depending on concentration, exhibits both bacteriostatic and bactericidal activity
Which organisms is Ciprofloxacin effective against?
Effective against Gram-negative bacteria
What are some side effects of Ciprofloxacin?
- Tendon rupture
2. Cartilage degeneration in skeletally immature patients
