Guidelines
Surgical Prophylaxis

Surgical Prophylaxis

Clinical/Diagnostic Considerations

Infusion of the first dose of antimicrobial should begin WITHIN 60 minutes of the surgical incision.

No antimicrobials are routinely required post-operatively unless in exceptional circumstances or if being used for treatment purposes

Since the side chain of cefazolin is different than penicillin or amoxicillin, patients who report an allergy to penicillin can safely be given cefazolin.

Exceptions are past history or SJS, DRESS, toxic epidermal necrolysis, acute generalized pustulosis, skin desquamation, hepatitis, nephritis, hemolytic anemia or serum sickness or prior reaction to cefazolin itself (only IV).

Prolonged operations require re-administration of IV antimicrobials to maintain therapeutic levels at the site of wound closure if the operation lasts twice the half life of the antibiotic, if there is excessive blood loss or extended use of cardiopulmonary bypass.

Doses quoted are for the intravenous route and for patients with normal renal function. Do not exceed the maximum adult dose.