Gastroduodenal surgery
- Duodenal / gastric resections for ulcers / cancer
- Perforated ulcer procedures
- Pancreaticoduodenectomy (Whipple's)
- Bariatric surgical procedures (gastric bypass, gastric banding, gastroplasty, biliopancreatic diversion)
- Gastroplasty – high risk only: gastric outlet obstruction, decreased gastric acidity or motility, morbid obesity, hemorrhage
Common Pathogens
Enterobacteriaceae
Gram positive cocci
| Regimen(s) of Choice See General Principles and Pre-Op Antibiotic Administration and Intraoperative Antibiotic Administration | ||
|---|---|---|
| Cefazolin | 2g IV | x 1 pre-op dose |
| Pre-op biliary stent in-situ, add: | ||
| Vancomycin | 15mg/kg IV | x 1 pre-op dose |
| Alternative Regimens if allergy to cefazolin, or severe non-IgE-mediated reaction to any β-lactam (interstitial nephritis, hepatitis, hemolytic anemia, serum sickness, severe cutaneous reactions [e.g. SJS, TEN, DRESS]) | ||
|---|---|---|
| Gentamicin | 1.5mg/kg IV | x 1 pre-op dose |
| + | ||
| Clindamycin | 600mg IV | x 1 pre-op dose |
| Pre-op biliary stent in-situ, use: | ||
| Gentamicin | 1.5mg/kg IV | x 1 pre-op dose |
| + | ||
| Vancomycin | 15mg/kg IV | x 1 pre-op dose |