Transcription of Re Dosing Guidelines for Complex cases Cases …
1 Re Dosing Guidelines for Complex casesCases longer than 4 hoursThe following are re Dosing Guidelines based on AntibioticsRe- Dosing IntervalCefazolin4 hoursCefoxitin4 hoursCiprofloxacin8 hoursClindamycin6hourspatients with normal renal function:Clindamycin6hoursErtapenem24 hoursGentamicin8 hours*Metronidazole8 hoursVancomycin12 hours**=Renal insufficiency (CrCl<50ml/min): 12 hoursFirst dose of antibiotic Should be within 1 hr prior toIncision time Renal insufficiency (CrCl50ml/min): 12 hours(CrCl <30ml/min, HD/CRRT): 24 hours**= Renal insufficiency (CrCl <30ml/min, HD/CRRT): 24 hoursABxABxDocument antibiotic, re dose and time At time of 1stDose document/mark on Anesthesia Record the time for re dosingUpdated 2/21/2011 Antibiotics SubcommitteePage 1 of 2 Antibiotic Prophylaxis:The Antibiotic Surgical Care Improvement Project (SCIP) measures include the following:Type of SurgeryAntimicrobial Recommendationspy1. Antibiotic received within one hour prior to surgical incision,2.
2 Antibiotic selection for surgical patients, and3. Antibiotics discontinued within 24 hours after surgery end time. (48 hrs for cardiac surgery)ypg yCardiac or VascularPreferred: Cefazolin 1-2 gm IV. IfB-lactam allergy:Clindamycin 600-900 mg IV or Vancomycin 1 g IV. If known history of MRSA: Vancomycin 1 g IVColonPreferred: Cefoxitin 1-2 g IV, or Ertapenem 1 g IV. gpgIf -LactamAllergy: Metronidazole 500 mg IV and Ciprofloxacin 400 mg IVGeneral Surgery (gastroduodenal, hepatobiliary)Preferred:Cefoxitin 1-2 g IV. If -Lactam Allergy: Metronidazole 500 mg IV and Ciprofloxacin 400 mg IVOther General Surgical Procedures ( hernia repair, breast)Preferred: Cefazolin 1-2 g IV. If -Lactam Allergy: Clindamycin 600-900 mg IV or Vancomycin 1 g IV. If known history of MRSA: Vancomycin 1 g IVGynecological Procedures (e g hysterectomy C-section)Preferred: Cefoxitin 1-2 g IV. If B-lactam allergy:Metronidazole 500 mg IV and Gentamicin IV or Metronidazole 500 mg IV ( hysterectomy, C-section)and Ciprofloxacin 400 mg IVNeurosurgeryPreferred: Cefazolin 1-2 gm IV.
3 If -Lactam Allergy: Clindamycin 600-900 mg IV or Vancomycin 1 g history of MRSA: Vancomycin 1 g IVOrthopedic: Hip/Knee Arthroplasty(infuse completely before tourniquet inflation)Preferred: Cefazolin 1-2 gm IV. If -lactam allergy: Clindamycin 600-900 mg IV or Vancomycin 1 g known history of MRSA: Vancomycin 1 g IV1/11 (15 1620)Page 2 of 2
