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Informatics in Pharmacy

Surgical Prophylaxis

August 26, 2018 By Dr. G, PharmD

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  • You must administer surgical prophylaxis at the time of the first incision or as close as possible.  Redose if surgery is longer than four hours.  No need for post-op, except in cardiac procedures.
  • Usually use cefazolin 2 g (3 g for patients above 120 kg), ceftriaxone, cefotetan, cefoxitin 2 g, clindamycin 900 mg, vancomycin 15 mg/kg
  • Cefazolin 2g is preferred in most cases, one dose unless surgery > 4 hours or cardiac procedures
    • Prophylaxis by surgical procedure
      • GI: Cefazolin 2g
      • Billary: Cefazolin, cefoxitin, cefotetan or ceftriaxone 2g, or amp/sulbactam 3g
      • Appendectomy: cefoxitin or cefotetan 2g or cefazolin + metronidazole (anaerobic coverage)
      • Colorectal: cefazolin or ceftriaxone 2g + metronidazole with or without neomycin and erythromycin
      • Gynocological: cefazolin, cefoxitin or cefotetan 2g
      • Cardiac: cefazolin or cefuroxime 2g
      • Orthopedic – cefazolin 2g
      • Urologic: None

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acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia bcps Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020