Contents

Search

prophylaxis for perioperative infection

Management: . surgical prophylaxis for wound infections - 1st generation cephalosporin - administer 2 hours preoperatively - cefazolin monotherapy is standard of care - addition of vanocomycin for total knee arthroplasty or hip arthroplasty of no benefit [4] - do not use broad-spectrum antibiotics for uncomplicated clean & clean-contaminated procedures [2] - perioperative prophylaxis should not continue after the incision is closed [2] - ceph Complications: - incidence of kidney injury & C difficile infection increases with increasing duration of antibiotic prophylaxis [3] - use of vancomycin increases risk of kidney injury for all types of surgery - use of clindamycin or fluoroquinolones increases risk of C difficile infection [3]

Related

surgery

General

antibiotic prophylaxis

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11,19 American College of Physicians, Philadelphia 1998. 2022
  2. American Academy of Pediatrics - Committee on Infectious Diseases and the Pediatric Infectious Diseases Society. Choosing Wisely. November 12, 2018 http://www.choosingwisely.org/societies/american-academy-of-pediatrics-committee-on-infectious-diseases-and-the-pediatric-infectious-diseases-society/
  3. Branch-Elliman W, O'Brien W, Strymish J et al. Association of duration and type of surgical prophylaxis with antimicrobial-associated adverse events. JAMA Surg 2019 Jul; 154:590. PMID: 31017647 https://jamanetwork.com/journals/jamasurgery/fullarticle/2731307 - Hawn MT, Knowlton LM. Balancing the risks and benefits of surgical prophylaxis: Timing and duration do matter. JAMA Surg 2019 Jul; 154:598. PMID: 31017641 https://jamanetwork.com/journals/jamasurgery/fullarticle/2731303
  4. Peel TN et al. Trial of vancomycin and cefazolin as surgical prophylaxis in arthroplasty. N Engl J Med 2023 Oct 19; 389:1488 PMID: 37851875 https://www.nejm.org/doi/10.1056/NEJMoa2301401