Surgical Prophylaxis Flashcards
Requirements for Effective Surgical Prophylaxis
Age
Nutritional status
Obesity
Diabetes
Tobacco use
Corticosteroid therapy
Recent surgical procedure
Length of preoperative hospitalization
Colonization with microorganisms
Predominate Organism Causing SSIs
Staphylococcus aureus
Coagulase-negative staphylococci
Organisms causing SSIs with abdominal surgery
Abdominal Surgery
Add gram-negative rods
Add enterococci
Risk factors of MRSA in Surgical PPx
known MRSA colonization
recent hospitalization
nursing-home residents
hemodialysis support
Surgical PPx drug administration?
Intravenous:
Preferred route of administration
Rapid, reliable, predictable serum & tissue concentrations
Surgical PPx Timing
60 mins prior to incision
120 mins prior for vanco and fluro due to infusions time
Preferred therapy for surgical PPx?
Cefazolin
Redosing Antimicrobial for surgical PPx?
Required to ensure adequate serum & tissue concentrations of the antimicrobial if the duration exceeds 2 half-lives of the antimicrobial agent
Approved to eradicate MRSA nasal colonization
Mupirocin
Mupirocin duration of therapy?
5 days prior to operation
Uncomplicated appendicitis Surgical PPx?
Single dose cefoxitin
OR cefotetan
OR cefazolin + metronidazole
Uncomplicated appendicitis Surgical PPx w/ Beta-lactam allergy?
Clindamycin + gentamicin
OR Metronidazole + gentamicin
OR Levofloxacin
Clean neurosurgical procedures Surgical PPx?
A single dose of cefazolin
Clean neurosurgical procedures Surgical PPx w/ Beta-lactam allergy?
Vancomycin OR clindamycin
Clean neurosurgical procedures Surgical PPx w/ MRSA colonized patients?
Vancomycin
