Prophylactic Antibiotic Regimen Selection

Bratzler et al. Antimicrobial Prophylaxis for Surgery: CID 2004:38
Administer no more than 1 hour prior to incision

  • Vascular/Hernia/Clean:
  • Cefazolin, Cefuroxime, Vancomycin
  • If β-lactam allergy: vancomycin, clindamycin
  • Colon:
  • Cefoxitin, Ampicillin/Sulbactam, or Ertapenem (single-dose)
    • OR
    • Cefazolin + Metronidazole
    •  
    • If β-lactam allergy:
    • Clinda + Aminoglycoside, or
    • Clinda + Quinolone, or
    • Clinda + Aztreonam
    •  
    • OR
    • Metronidazole + Aminoglycoside
    • Metronidazole + quinolone
    •  
  • Esophageal, gastroduodenal: cefazolin
  • Biliary tract: cefazolin
  • Appendectomy, non-perf: cefazolin + metronidazole
  •  
  • If β-lactam allergy: clinda + gentamicin, ciprofloxacin, aztreonam