Pre-Op Antibiotic Administration
Timely administration (within 60 minutes before initial skin incision) of antibiotic prophylaxis can significantly decrease the incidence of postoperative infections. The goal is to achieve optimal serum and tissue antibiotic concentrations at the time of the initial skin incision and for the duration of the procedure. To best achieve this, antibiotics can be given in the operating room (OR) by the anesthesiologist at induction of anaesthesia, but depending on the circumstances of the procedure may also be given in the holding area, or on the patient care unit if prolonged infusion is necessary. Administering antibiotics “on call to the OR” is not recommended as it often results in suboptimal antibiotic concentrations due to surgery schedule changes or transport delays.
Prophylactic Antibiotic | Adult Dose | Administration |
---|---|---|
Cefazolin IV | 2g | IV push within 60 minutes before initial skin incision |
Cefuroxime IV | 1.5g | IV push within 60 minutes before initial skin incision |
Ceftriaxone IV | 1g | IV push within 60 minutes before initial skin incision |
Ciprofloxacin PO | 500mg | Administer 1-2 hours pre-op |
Clindamycin IV | 600mg | Administer over 20 minutes just prior to procedure |
Co-trimoxazole PO | 1 DS tablet | Administer 1-2 hours pre-op |
Gentamicin IV |
1.5mg/kg
OR |
Administer over 30 minutes just prior to procedure Administer over 60 minutes just prior to procedure |
Levofloxacin IV | 500mg | Administer over 60 minutes just prior to procedure |
Metronidazole IV | 500mg | Administer over 20 minutes just pror to procedure |
Vancomycin IV | 15mg/kg | Administer ≤ 1g over at least 60 minutes > 1g - 1.5g over at least 90 minutes, and > 1.5g over 120 minutes just prior to procedure |