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.
2 antibiotic received within one hour prior to surgical incision,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.
3 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. 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
