Term
| What are the 2 different types of antibiotic regimens? |
|
Definition
- Prophylaxis - prevention of infection. Prior to contamination
- Treatment - when an infection has been identified |
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Term
| What are the different types of surgical procedures? |
|
Definition
- Clean - no break, nontraumatic
- Clean-contaminated - Involved GI/GU/Respiratory without spillage
- Contaminated - wound from clean source OR Operation w/ break in technique
- Dirty infected - Procedure when active infection is present
**Do not need prophylaxis for clean |
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Term
| What 4 ways can Surgical infections be reduced? |
|
Definition
- Aseptic technique
- Treat remote sites of infection
- Minimize OR traffic
- Avoid shaving
**RX: Prophylaxis, bowel prep, use of iodine/chlorhexidine |
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Term
| When is the greatest benefit obtained by prophylactic antibiotics? |
|
Definition
Within 60 minutes of incision - 120 min for Vanc and FQNs
**repeat 2 half lives after 1st dose if operation still in progress. Continue 24 hrs post op, 48 for cardiac |
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Term
| What are the top 4 pathogens in surgery? |
|
Definition
- Staph aureus/MRSA - not in colon
- Staph - not in colon
- Enterococci
- E. Coli
**Depends on anatomic site |
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Term
| How is prophylaxis done for head/neck surgery? |
|
Definition
- Caused by S. aureus or Strep anaerobes
- Cefazolin 2g or Clinda 600 mg |
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Term
| How is prophylaxis done for gynecological surgery? |
|
Definition
- caused by GNB, anaerobes, strep, enterococci
- Cefazolin 2g, metronidazole in a PCN allergy |
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Term
| How is prophylaxis done for Orthopedic surgery? |
|
Definition
- Caused by S. aureus and S. epidermidis
- Cefazolin and for 24 hours. Hip replacement x48 hours. +gent for severe fractures |
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Term
| How is prophylaxis done for Genitourinary surgery? |
|
Definition
- Caused by E. coli
- In high risk patients only: Cipro or bactrim x1 |
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Term
| How is prophylaxis done for cardiothoracic surgery? |
|
Definition
- Caused by S. aureus, S. epidermidis, Corynebacterium
- Cardiac - Cefazolin 1g q8h x48h. 2g in high weight patients
- Thoracic - Cefuroxime 750 q8h x48
**Longer duration in cardiac surgery |
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Term
| How is prophylaxis done for Vascular/neuro/GI surgery? |
|
Definition
- caused by S. aureus, S. epidermidis, GNB
- Vascular: Cefazolin 1 g at induction and q8h x2 more doses
- Neuro: Cefazolin 1 dose. only strep and Staph
- GI: Only GNB and anaerobes. Cholecyst use cefazolin in HIGH risk pts. endoscopy: Amox or ampi in HIGH risk. TIPS = Ceftriaxone. Colorectal - Neomycin + E-mycin
**High MRSA: Vanc |
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|
Term
| How is a bowel prep done? |
|
Definition
- PEG solution to clear bowel
- Neomycin + E-mycin @ 19, 18, 9 hours before surgery |
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|
Term
| What is the most common agent is surgical prophylaxis? |
|
Definition
Cefazolin 1-2g
Specifically Neuro, Cardiac, orthopedic
**Vanc in MRSA populations, PCN allergy |
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