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  • Antibiotic Prophylaxis: Francis Neil C. Caranay

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    This document discusses antibiotic prophylaxis, which is the use of antibiotics prior to surgery to prevent infections. It describes the different wound classes based on contamination and when prophylaxis is generally required. The key aspects of administering prophylaxis are covered, including choosing an antibiotic based on the expected pathogens and resistance patterns, timing administration within 60 minutes before surgery, using a single dose with a long half-life, and typically administering intravenously. Common antibiotics used for different surgical sites are listed. The risks of prophylaxis include allergies, diarrhea, and antibiotic resistance.

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    This document discusses antibiotic prophylaxis, which is the use of antibiotics prior to surgery to prevent infections. It describes the different wound classes based on contamination and when prophylaxis is generally required. The key aspects of administering prophylaxis are covered, including choosing an antibiotic based on the expected pathogens and resistance patterns, timing administration within 60 minutes before surgery, using a single dose with a long half-life, and typically administering intravenously. Common antibiotics used for different surgical sites are listed. The risks of prophylaxis include allergies, diarrhea, and antibiotic resistance.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    71 views11 pages

    Antibiotic Prophylaxis: Francis Neil C. Caranay

    Uploaded by

    Ndor Baribolo
    This document discusses antibiotic prophylaxis, which is the use of antibiotics prior to surgery to prevent infections. It describes the different wound classes based on contamination and when prophylaxis is generally required. The key aspects of administering prophylaxis are covered, including choosing an antibiotic based on the expected pathogens and resistance patterns, timing administration within 60 minutes before surgery, using a single dose with a long half-life, and typically administering intravenously. Common antibiotics used for different surgical sites are listed. The risks of prophylaxis include allergies, diarrhea, and antibiotic resistance.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 11

    Antibiotic Prophylaxis

    Francis Neil C. Caranay


    Antibiotic Prophylaxis
    Antimicrobial therapy to prevent infection
    Given to patients prior to a surgical
    procedure
    Indications
    Class 1 – Clean wounds with implants
    Class 2 – Clean contaminated wounds
    Class 3 – Contaminated wounds
    Class 4 – Dirty wounds
    Wound Class and Representative
    Procedures
    Wound Class Examples of Cases
    Class I (Clean) Hernia repair, breast biopsy
    Class II (Clean-contaminated) Cholecystectomy, elective GI surgery,
    Colorectal surgery
    Class III (Contaminated) Penetrating abdominal trauma, large
    tissue injury, enterotomy during bowel
    obstruction

    Class IV (Dirty) Perforated diverticulitis, necrotizing


    soft tissue infections
    Source: Schwartz’s Principles of Surgery. 9th ed. table 6-8

    *Prophylactic antibiotics NOT generally required for Class I


    Administration of Antibiotic Prophylaxis
    Choice of antibiotic
    ◦ Antibiotic must cover expected pathogens
    ◦ Must take into account local resistance
    patterns
    ◦ First choice should be narrow spectrum and
    less expensive antibiotics
    Timing of administration
    ◦ IV prophylactic antibiotics should be given
    within 60 minutes before skin is incised
    ◦ IV Vancomycin given starting 90 minutes
    prior to skin incision
    ◦ For Caesarean section, antibiotic is given pre-
    incision or after cord clamping
    Duration of prophylaxis
    ◦ Single dose of antibiotic with long enough
    half-life lasting throughout the operation
    ◦ Up to 24 hours for arthroplasty
    ◦ Additional dosage for cardiac surgery longer
    than 4 hours
    Route of administration
    ◦ Antibiotics should be administered
    intravenously
    ◦ Other routes:
     Topical
     Intranasal
     Impregnated cement
     Intracameral
    Antibiotic agents used
    Penicillins
    Cephalosporins
    Ampicillin
    – sulbactam
    Vancomycin
    Prophylactic use of Antibiotics
    Site Antibiotic Alternative
    Cardiovascular Surgery Cefazolin, cefuroxime Vancomycin
    Gastroduodenal area Cefazolin, cefoteta, cefoxitin, Fluoroquinolone
    ampicillin-sulbactam
    Biliary tract with active Ampicillin-sulbactam, Fluoroquinolone plus
    infection ticarcillin-clavulanate, clindamycin or
    piperacillin-tazobactam metronidazole
    Colorectal surgery, Cefazolin plus metronidazole, Gentamicin or
    obstructed ertapenem, ticarcillin,- fluoroquinolone plus
    small bowel clavulanate, piperacillin- clindamycin or
    tazobactam metronidazole

    Head and neck Cefazolin Aminoglycoside plus


    clindamycin
    Neurosurgical Cefazolin Vancomycin
    procedures
    Orthopedic surgery Cefazolin, ceftriaxone Vancomycin
    Breast, hernia Cefazolin Vancomycin

    Source: Schwartz’s Principles of Surgery. 9th ed. table 6-6


    Risks of Prophylaxis
    Allergies/Anaphylaxis
    Antibiotic-associated diarrhea
    Antibiotic resistance

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