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Transcript
GI:
Appendectomy3
Gynecologic
Anaerobic organisms
(especially B fragilis) and
Gram-negative enteric
organisms
(predominantly E coli).
Staphylococcus,
Enterococcus and
Pseudomonas species
have also been reported.
Uncomplicated:
Uncomplicated:
• Cefoxitin 1 g IV pre-op
(2 g if > 80 kg)
Complicated:
• Cefoxitin 30mg/kg IV
(Maximum of 2 g) preop
LIKELY
PATHOGENS
ANTIMICROBIAL REGIMEN
(Adult)
Lactobacillus sp.
Staph aureus
Corynebacterium sp.
Gram-negative
organisms
Anaerobes
• Cefazolin4 2 g IV
4
• Unasyn®
(ampicillin/sulbactam)
1.5-3 g IV pre-op
---- Or
• Unasyn® every 4
hours
The incidence of infectious
complications following
appendectomy is dependent on
the condition of the appendix at
the time of surgery
ANTIMICROBIAL REGIMEN
(Pediatric)
OR REDOSING
COMMENTS
• Cefazolin 25mg/kg IV preop
(Maximum of 1 g)
• Cefazolin every 4
hours
Complicated:
• Cefoxitin every 3
hours
• Unasyn
(ampicillin/sulbactam)
37.5mg/kg (provides
25mg/kg of ampicillin) IV
(Maximum of 3 g) preop
---- Or
4
Cefoxitin 2 g IV
---- Or
• Clindamycin 900 mg Q8H IV
plus gentamicin 1.7 mg/kg
IV 30 min pre-op for
penicillin-allergic patients
• Cefoxitin 30mg/kg IV
(Maximum of 2 g) preop
---- Or
• Cefoxitin every 3
hours
• Clindamycin 10mg/kg IV
(Maximum of 900mg) plus
gentamicin 2mg/kg IV
(Maximum of 80mg) preop
for penicillin-allergic patients
• Clindamycin every 6
hours