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
Dosing for Operative Antibiotic Prophylaxis
Guideline · Aug 2019 · 1 min read
In brief
In brief
Guidelines for appropriate antibiotic dosing in surgical prophylaxis to prevent surgical site infections while minimizing antimicrobial resistance and adverse effects.
Written by the GCMD Library team from the guideline.
General Principles for Antibiotic Prophylaxis
All dosing recommendations assume normal renal and hepatic function. Consultation with infectious disease and pharmacy is recommended for patients with multiple allergies, complex infection history, organ dysfunction, or ongoing antibiotic therapy.
Pre-operative Antibiotics for Patients NOT on Antibiotics
Prophylactic antibiotics should be administered within 60 minutes prior to incision. MRSA-positive patients require a single pre-operative dose of vancomycin in addition to routine prophylaxis, and redosing should follow protocol timing or occur with excessive blood loss.
Pre-operative Antibiotics for Patients Currently ON Antibiotics
If current treatment antibiotics are appropriate for perioperative prophylaxis, continue the existing schedule and follow intraoperative redosing intervals. If treatment antibiotics are not appropriate for prophylaxis, consider adding routine pre-operative prophylaxis, with vancomycin added for MRSA-positive patients.
Post-operative Antibiotic Continuation
Routine prophylactic antibiotics should be discontinued after incision closure and not continued postoperatively. Redosing in the operating room prior to closure should be considered if closure is anticipated within 30 minutes of the usual redosing interval, with the first post-operative dose timed from the last pre-closure dose.
Statements in this guideline
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-operative dose should be completed within 60 minutes prior to the incision.
Patients who screen positive for MRSA should be given a single 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.
If treatment antibiotics appropriate for perioperative antimicrobial prophylaxis, continue schedule and follow intraoperative redosing table for timing of next dose.
If treatment is not appropriate for perioperative antimicrobial prophylaxis, consider routine pre-op prophylaxis in addition to concurrent therapy.
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.