Infectious Diseases II: Perioperative antibiotics/meningitis treatment Flashcards
When should perioperative antibiotics be given?
within 60 mins of the incision
120 mins if using FQ’s or vanco (longer infusion)
When would you consider giving another dose of antibiotic during surgery?
If the surgery is greater than 3-4 hrs
Duration of perioperative prophylaxis:
Usually 1 dose is sufficient
Sometimes continue for 24 hrs after surgery
Most common antibiotics for surgery prophylaxis
1st or 2nd gen cephalosporins (mostly cover gram+)
Recommended antibiotic for cardiac/vascular surgery and hip surgery
Cefazolin
Recommended antibiotic for cardiac/vascular surgery and hip surgery with pts with a beta lactam allergy
Vanco or clindamycin
Recommended antibiotics for colorectal surgery
Cefotetan, cefoxitin ( 2nd gen ceph with anaerobic coverage)
ampicillin/silbactam
ertapenem
cefazolin/ceftriaxone + metronidazole
Recommended antibiotics for coloreactal surgery (beta lactam allergy)
Clinda + AG or FQ or Aztronam
metronidazole + AG or FQ
3 classic symptoms of meningitis
severe HA
stiff neck
altered mental status
What groups are more likely to meningitis caused by Listeria
Neonates
Pt > 50 y/o
immunocompromised
What steroid is used in the treatment of meningitis?
Dexamthasone
given before or with dose
0.165 m/kg q6h x 4
Antibiotic duration for N. meningitidis and H. influenzae infections
7 days
Antibiotic duration for s. pneumoniae infections
10-14 days
ANtibiotic duration for Listeria infections
21 days
Empiric meningitis treatment for pts < 1 mon
AMpicillin
+
Cefotaxime (or Gentamicin)
NO CEFTRIAXONE
