Elective colorectal surgery
Common Pathogens
Enterobacterales
Anaerobes
| Regimen(s) of Choice See General Principles and Pre-Op Antibiotic Administration and Intraoperative Antibiotic Administration | ||
|---|---|---|
| Mechanical bowel preparation | ||
| then | ||
| [Neomycin | 1g PO | at 1300h, 1500h, 2000h day before surgery |
| + | ||
| Metronidazole] | 1g PO | at 1300h, 1500h, 2000h day before surgery |
| + | ||
| [Cefazolin | 2g IV | x 1 pre-op dose |
| + | ||
| Metronidazole] | 500mg 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]) | ||
|---|---|---|
| Mechanical bowel preparation | ||
| then | ||
| [Neomycin | 1g PO | at 1300h, 1500h, 2000h day before surgery |
| + | ||
| Metronidazole] | 1g PO | at 1300h, 1500h, 2000h day before surgery |
| + either of these 2 IV regimens: | ||
| [Gentamicin | 1.5mg/kg IV | x 1 pre-op dose |
| + | ||
| Clindamycin] | 600mg IV | x 1 pre-op dose |
| or | ||
| [Gentamicin | 1.5mg/kg IV | x 1 pre-op dose |
| + | ||
| Metronidazole] | 500mg IV | x 1 pre-op dose |