Dosing for Operative Antibiotic Prophylaxis

General Principles•All dosing recommendations are for patients with normal renal and/or hepatic function. •Consider consultation with ID and pharmacy in cases of multiple allergies, complex infection history, hepatic or renal dysfunction, and with ongoing pre-operative antibiotic therapy.Pre-and intra-operative antibioticsFor patients NOTcurrently on antibiotics: •Pre-operative dose should be completed within 60 minutes prior to the incision.•Patients who screen positive for MRSA should be given a singly pre-operative dose of vancomycin in addition to routine prophylaxis•Re-dose prophylactic antibiotic according to times in the table or if the patient has experienced excessive blood loss.For patients currently ONantibiotics: •If treatment antibiotics appropriate for perioperative antimicrobial prophylaxis (AMP), continue schedule/follow intraoperative redosing table for timing of next dose.•If treatment is not appropriate for perioperative AMP, consider routine pre-op prophylaxis in addition to concurrent therapy.•Patients who screen positive for MRSA should be given a singly pre-operative dose of vancomycin in addition to routine prophylaxisPost-operative continuation•For routine prophylaxis, antibiotics should not be continued after the incision is closed. •Redosing in the OR prior to closure should be considered if closure is anticipated within 30 minutes of the usual redosing time. •The first post-operative dose is timed off of last dose given prior to incision closure. •Operative guidance table does not apply to post-op dosing or intervals. Updated 1/2019 v1.0 Source: http://centerlink.cchmc.org/specialgroups/infection-control/dosing-table-for-operative-prophylaxis