MCW & FMLH Antibiotic Guide. Suggested Recommendations and Guidelines for Surgical Prophylaxis
|
|
- Dortha Brooks
- 6 years ago
- Views:
Transcription
1 MCW & FMLH Antibiotic Guide This guide was prepared by members of the Antibiotic Subcommittee of the Pharmacy and Therapeutics Committee and has been approved for use at Froedtert Hospital. Suggested Recommendations and Guidelines for Surgical Prophylaxis Introduction Postoperative wound infections are the major source of infectious morbidity in the surgical patient. The use of perioperative antibiotics has become an essential component of the standard of care in virtually all surgical procedures and has resulted in a reduced risk of postoperative infection when sound and appropriate principles of prophylaxis are applied. I. There is probable risk of infection in the absence of a prophylactic agent. II. There is a knowledge of the probable contaminating flora associated with the operative wound or organ site. III. The activity of the chosen prophylactic agent should encompass the majority of pathogens likely to contaminate the wound or operative site. IV. When more than one choice is given as a prophylactic agent, the agents or agents selected should be based on the most likely contaminating organisms. V. The prophylactic agent must be administered in a dose which provides an effective tissue concentration prior to intraoperative bacterial contamination. Administration must occur 30 minutes prior to incision (usually with the induction of anesthesia). VI. The effective dose should be governed by the patient's weight. For cephalosporins, patients weighing >60 kg, dosage should be doubled (i.e., ²60 kg: cefazolin 1 g IV, >60 kg: cefazolin 2 g IV). VII. In procedures lasting 3 hour or less, a single prophylactic dose is usually sufficient. Procedures lasting greater than three hours require an additional effective dose. Procedures in which there is rapid blood loss and/or fluid administration will dictate more frequent prophylactic dosing. Under no circumstance should any prophylactic agent be given on-call because it often results in less than effective tissue levels at the time of incision. Postoperative prophylaxis is strongly discouraged except in the scenario of a bioprosthetic insertion in which case 2 or 3 additional prophylactic doses may be deemed sufficient (Warning: there are no standard rules on prophylaxis following prosthetic insertion and clinical experience strongly dictates practice).
2 VIII. IX. Vancomycin may be used for patients with severe penicillin/cephalosporin allergy. An effective and thoughtful prophylactic regimen is no substitute for exquisite surgical technique and competent postsurgical management. I. General Surgery a. Clean Procedures Under most circumstances antimicrobial prophylaxis is not required when performing a clean surgical procedure. However, prophylaxis should be employed under those conditions where there is a potential intrinsic risk of infections such as in: I. Insertion of a synthetic biomaterial device or prosthesis II. Clean operations performed in a patients with impaired host defenses Agents: Cefazolin or cefuroxime. Route/Dosage/Timing: 1 gram cefazolin IV or 750 mg cefuroxime IV 30 minutes before skin incision; second dose if procedure >3 hours. Rationale: Likely infecting organism are gram-positive cocci (S. aureus or S. epidermidis) and aerobic coliforms (E. coli). b. Upper GI & Elective Small Bowel (Stomach, Small Bowel, Pancreas, Hepatobiliary) Agents: Ceftizoxime OR ceftizoxime + metronidazole if anarobes suspected. Route/Dosage/Timing: 1 gram ceftizoxime (500 mg metronidazole) IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Likely contaminating organisms: Coliforms > Enterococcus > streptococci > anaerobic clostridia, peptostreptococci, Bacteroides, Prevotella or Porphyromonous (formerly oral Bacteroides). c. Large Bowel Resections Agents: Oral mechanical prep (Neomycin/Erythromycin) and parenteral cephalosporin (ceftizoxime or cefotetan). Preoperative Day
3 Oral sodium phosphate solution (Fleets-Phosph-Soda) with or without bisacodyl in a one or two dose regimen before giving antibiotics. A nasogastric tube may be required in some patients. Clear liquid diet only. Administer neomycin plus erythromycin base po at 1 PM, 2 PM and 10 PM; keep NPO after midnight (first dose given >= 20 h before surgery). Operative Day Completely evacuate the bowel prior to operation. Parenteral drug administration 30 minutes prior to incision. Route/Dosage/Timing: 1 gram ceftizoxime or cefotetan IV 30 minutes prior to incision; second dose if procedure lasts > 3 hours. Rationale: Likely flora includes coliforms, Enterococcus, Bacteroides, peptostreptococci and clostridia. d. Acute Appendectomy (Non-perforated) Agents: Single agent: Ceftizoxime or cefotetan. Combination therapy: Ceftizoxime plus metronidazole. Route/Dosage/Timing: Single agent: 1 gram ceftizoxime or cefotetan IV 30 minutes before skin incision; second dose if procedure > 3 hours. Combination therapy: 1 gram ceftizoxime IV plus 500 mg metronidazole IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Coliforms and anaerobic bacteria likely contaminants. Note: In perforated or gangrenous cases, clinical situation becomes therapeutic and Rx is continued as clinically indicated II. Trauma Surgery a. Penetrating Abdominal Trauma Agents: Single agent: Cefotetan. Combination therapy: Ceftizoxime plus metronidazole. Route/Dosage/Timing: 2 grams cefotetan IV or 2 grams ceftizoxime plus 500 mg metronidazole IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Coliform and anaerobic bacteria (gram-positive & gram-negative) present in peritoneal cavity follow bowel injury.
4 III. Obstetrics and Gynecology a. Vaginal or Abdominal Hysterectomy (Including Radical) Agents: Cefazolin or ceftizoxime or cefotetan. Route/Dosage/Timing: 1 gram cefazolin, ceftizoxime, or cefotetan IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Coliforms, Enterococcus, Streptococcus, clostridia and Bacteroides are potential infecting organisms. b. Cesarean Section/Hysterectomy Agents: Cefazolin or ceftizoxime. Route/Dosage/Timing: 1 gram cefazolin or ceftizoxime IV 30 minutes before skin incision; in high risk patients, may use 2 grams cefazolin or ceftizoxime IV after clamping and cutting of umbilical cord. Rationale: Coliforms, Enterococcus, Streptococcus, clostridia and Bacteroides potential contaminants. IV. Urology a. Prostatectomy Agents: Cefazolin or ciprofloxacin. Route/Dosage/Timing: 1 gram cefazolin IV OR 400 mg ciprofloxacin IV 30 minutes before skin incision; second dose of either cefazolin or ciprofloxacin after procedure. Rationale: Coliforms and staphylococci are major contaminant, pseudomonads occasional pathogen.
5 V. Transplant Surgery a. Kidney Transplantation Agents: Cefazolin or cefuroxime. Route/Dosage/Timing: 1 gram cefazolin IV or 750 mg cefuroxime IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Staphylococci are the predominant contaminants. b. Liver Transplantation Agents: Beta-lactam with beta-lactamases inhibitor (ampicillin/sulbactam). Route/Dosage/Timing: 3 grams ampicillin/sulbactam IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Coliforms, enterococci and staphylococci potential contaminating organisms. c. Pancreas or Kidney/Pancreas Agents: Ampicillin/sulbactam with fluconazole. Route/Dosage/Timing: 3 grams ampicillin/sulbactam IV plus 400 mg fluconazole IV 30 minutes before skin incision. Rationale: Donor duodenum is often colonized with gram positive organisms such as Staphylococcus epidermis, enterococcus, and yeast. VI. Head and Neck Surgery a. Clean Procedures (skin excision, neck dissections) Agents: Cefazolin or penicillin G. Route/Dosage/Timing: 1 gram cefazolin IV or 2-4 MU penicillin G IV 30 minutes before skin incision; second dose if procedure > 3 hours.
6 Rationale: Coverage against staphylococcal flora. b. Laryngectomy & Other Head and Neck Cancer Operations Agents: Cefazolin or ceftriaxone plus metronidazole. Route/Dosage/Timing: 1 gram cefazolin or ceftizoxime IV and 500 mg metronidazole IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Coverage against skin staphylococci plus oral anaerobic bacteria. c. Mandibular Fractures Agents: Penicillin. Route/Dosage/Timing: 2 MU penicillin (>60 kg use 4 MU) IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Coverage for oral flora. VII. Orthopaedic Surgery a. Total Joint Replacement Agents: Cefazolin or cefuroxime. Route/Dosage/Timing: 1 gram cefazolin or 750 mg cefuroxime IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Staphylococci are major infecting organism in joint replacement surgery. b. Traumatic Open Fractures
7 Agents: Cefazolin (grade I & II fractures); ceftizoxime (grade III fractures). Route/Dosage/Timing: 2 gram cefazolin or ceftizoxime IV 30 minutes before incision; second dose if procedure > 3 hours. Rationale: Staphylococcal skin flora common contaminant in grade I and II fractures, coliforms often infect the serious grade III fractures. VIII. Vascular Surgery a. Peripheral Vascular Procedures Agents: Cefazolin. Route/Dosage/Timing: 1 gram cefazolin IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Staphylococci major contaminant. IX. Cardiothoracic Surgery, Coronary Bypass Surgery, and Pulmonary Resection Agents: Cefazolin or cefuroxime.
8 Route/Dosage/Timing: 1 gram cefazolin or 750 mg cefuroxime IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Staphylococci most common contaminating organism. X. Neurosurgery Agents: Cefazolin. Route/Dosage/Timing: 1 gram cefazolin IV 30 minutes before skin incision; second dose if procedure > 3 hours. Rationale: Staphylococci are the predominant isolates from neurosurgical wound infections. References Introduction Nichols RL. Postoperative wound infection. N Engl J Med 307:1701, Ulualp, K., and Condon, R.E.: Antibiotic prophylaxis for scheduled operative procedures. In Dellinger E (ed): Surgical Infections. Infectious Disease Clinics of North America, Philadelphia, PA, W.B. Saunders Company, 1992.
9 Wittman DH, Condon RE. Prophylaxis of postoperative infections. Infection 19:S337-S344, General Surgery Bauer T. Vennits BO, Holm B. et al. Antibiotic prophylaxis in acute non-perforated appendicitis. Ann Surg 209:307, Browder W. Smith JW, Vivoda L, et al. Nonperforative appendicitis: a continuing surgical dilemma. J Infect Dis 159:1088,1989. Condon RE, Bartlett JG, Greenlee H, et al. Efficacy of oral and systemic antibiotic prophylaxis in colorectal operations. Arch Surg 118:496, Culver DH, Horan TC, Gaynes RP, et al. Surgical wound infection rates by wound class, operative procedure and patient risk index. Am J Med 91 (Suppl 3B):152S157S. Jagelman PG, Fabian TC, Nichols RL, et al. Single dose cefotetan versus multipledose cefoxitin as prophylaxis in colorectal surgery. Am J Surg 155 (5A):71, Nichols RL, Webb WR, Jones JW, et al. Efficacy of antibiotic prophylaxis in high risk gastroduodenal operations. Am J Surg 143:94, Platt R. Zaleznik DF, Hopkins CC, et al. Perioperative antibiotic prophylaxis for
10 herniorrhaphy and breast surgery. N Engl J Med 322:153, Ulualp K, and Condon RE. Antibiotic prophylaxis for scheduled operative procedures. In Dellinger E (ed): Surgical Infection. Infectious Disease Clinics of North America, Philadelphia, PA, WB Saunders Company, Trauma Surgery Dellinger EP, Wertz MJ, Lennard ES, et al. Efficacy of short course antibiotic prophylaxis after penetrating intestinal trauma. Arch Surg 121:23, Dellinger EP. Antibiotic prophylaxis in trauma: penetrating abdominal injuries and open fractures. Rev Infect Dis 13 (Suppl):S847, Nichols RL, Smith JW, Robertson GD, Muzik AC, Pearce P. Ozmen V, McSwain NE, Flint LM. Prospective alterations in therapy for penetrating abdominal trauma. Arch Surg 128:55, Page CP, Bohnen JMA, Fletcher JR, McManus AT, Solomkin JS, Wittmann DH. Antimicrobial prophylaxis for surgical wounds: Guidelines for critical. Arch Surg 128:79, Obstetrics and Gynecology Antimicrobial Prophylaxis in Surgery, Med Lett 31:105, Gorbach SL. The role of cephalosporins in surgical prophylaxis. J Antimicrob Chemother 23 (Suppl D): 61, 1989.
11 Hemsell DL. Prophylactic antibiotics in gynecologic and obstetric surgery. Rev Infect Dis 13 (Suppl 10):S821, McGregor JA, Phillips LE, Dunne JT, et al. Results of double-blind, placebo-controlled clinical trial of si.ngle dose ceftizoxime vs. multiple dose cefotetan as prophylaxis for patients undergoing vaginal and abdominal hysterectomy. J Am Coll Surg 175; , Urology Hofer DR, Schaeffer AJ. Use of antimicrobials for patients undergoing prostatectomy. Uron Clin North Am 17:595, Head and Neck Surgery Becker GD, Parell GJ, Busch DF, et al. Anaerobic and aerobic bacteriology in head and neck surgery. Arch Otolaryngol 104:591, Byers RM, Fainstein V, Schantz SP, et al. Wound prophylaxis with metronidazole in head and neck surgical oncology. Laryngoscope 98: 803, Orthopaedic Surgery Benson DR, Riggin RS, Lawrence RM, et al. Treatment of open fractures: a prospective study. J Trauma 23:25, Dellinger EP. Antibiotic prophylaxis in trauma: penetrating abdominal injuries and open fractures. Rev Infect Dis 13(Suppl):S847, l991.
12 Gorbach SL, Condon RE, Conte JE, et al. Evaluation of new antiinfective drugs for surgical prophylaxis. Clin Infect Dis 15(Suppl):S313, Norden CW, Antibiotic prophylaxis in orthopaedic surgery. Rev Infect Dis 13 (Suppl):S842, Vascular Surgery Hopkins CC. Antibiotic prophylaxis in clean surgery: peripheral vascular surgery, noncardiovascular thoracic surgery, herniorrhaphy and mastectomy. Rev Infect Dis 13(Suppl):S869, Kaiser AB, Roach AC, Mulherin J, et al. The costeffectiveness of antimicrobial prophylaxis in clean vascular surgery. J Infect Dis 147:1103, Cardiothoracic Surgery Ariano RE, Zhanel GG. Antimicrobial prophylaxis on coronary bypass surgery: a critical appraisal. DICP Ann Pharmacother 25:478, Ilves R. Cooper JD, Todd TRJ, et al. Prospective, randomized, doubleblind study using prophylactic cephalothin for major, elective general thoracic surgery. J Thorac Cardiovasc Surg 81:813, Slama TG, Sklar SJ, Misinski J. et al. Randomized comparison of cefamandole, cefazolin and cefuroxime prophylaxis in open heart surgery. Antimicrob Agents Chemother 29:744, Neurosurgery
13 Dempsey R. Rapp RP, Young B. Prophylactic parenteral antibiotics in clean neurosurgical procedures: a review. J Neurosurg 69:52, Return to TABLE OF CONTENTS last update 10/22/97 WWW version maintained for the hospital P&T committee by: Gary P. Barnas, M.D., Office of Clinical Informatics send comments to: Cindy Hennen, R.Ph.
VCH PHC SURGICAL PROPHYLAXIS RECOMMENDATIONS
VCH PHC SURGICAL PROPHYLAXIS RECOMMENDATIONS CARDIAC Staphylococcus aureus, S. epidermidis, except for For patients with known MRSA colonization, recommend decolonization with Antimicrobial Photodynamic
More informationSHC Surgical Antimicrobial Prophylaxis Guidelines
SHC Surgical Antimicrobial Prophylaxis Guidelines I. Purpose/Background This document is based upon the 2013 consensus guidelines from American Society of Health-System Pharmacists (ASHP), the Infectious
More informationSSI PREVENTION - CORRECT AND SAFE SURGICAL ANTIBIOTIC PROPHYLAXIS
SSI PREVENTION - CORRECT AN SAFE SURGICAL ANTIBIOTIC PROPHYLAXIS Things you should know! There is wide consensus on specific procedures that warrant antibiotic prophylaxis as well as in which procedures
More informationMeasure Information Form
Release Notes: Measure Information Form Version 2.4 **NQF-NORS VOLUNTARY CONSNSUS STANARS FOR HOSPITAL CAR** Measure Information Form Measure Set: Surgical Care Improvement Project (SCIP) Set Measure I
More informationProphylactic antibiotics in penetrating abdominal trauma: Outcome data
Prophylactic antibiotics in trauma: Outcome data Author & Reference Title Class Antibiotics #Pts Duration (days) Organs injured The duration of Bozorgzedeh A antibiotic administration I cefoxitin 148 24
More informationMeasure #20 (NQF 0270): Perioperative Care: Timing of Prophylactic Parenteral Antibiotic Ordering Physician
Measure #20 (NQF 0270): Perioperative Care: Timing of Prophylactic Parenteral Antibiotic Ordering Physician 2014 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage of surgical
More informationProphylactic antibiotic timing and dosage. Dr. Sanjeev Singh AIMS, Kochi
Prophylactic antibiotic timing and dosage Dr. Sanjeev Singh AIMS, Kochi Meaning - Webster Medical Definition of prophylaxis plural pro phy lax es \-ˈlak-ˌsēz\play : measures designed to preserve health
More informationAntimicrobial prophylaxis. Bs Lưu Hồ Thanh Lâm Bv Nhi Đồng 2
Antimicrobial prophylaxis Bs Lưu Hồ Thanh Lâm Bv Nhi Đồng 2 Definition The United States Centers for Disease Control and Prevention (CDC) has developed criteria that define surgical site infection (SSI)
More informationIn an effort to help reduce surgical site infections, Surgical Services associates will be expected to observe the following guidelines:
To: Dept. of Surgery Associates From: Gloria Karr, Dir. Infection Prevention Date: May, 2012 Re: Guidelines for Infection Control in In an effort to help reduce surgical site infections, Surgical Services
More informationASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery
426 ASHP Therapeutic Guidelines ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery The ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery, 1 which have provided practitioners
More informationGive the Right Antibiotics in Trauma Mitchell J Daley, PharmD, BCPS
Give the Right Antibiotics in Trauma Mitchell J Daley, PharmD, BCPS Clinical Pharmacy Specialist, Critical Care Dell Seton Medical Center at the University of Texas and Seton Healthcare Family Clinical
More informationAntibiotic Prophylaxis Update
Antibiotic Prophylaxis Update Choosing Surgical Antimicrobial Prophylaxis Peri-Procedural Administration Surgical Prophylaxis and AMS at Epworth HealthCare Mr Glenn Valoppi Dr Trisha Peel Dr Joseph Doyle
More informationCefuroxime 1.5gm IV and Metronidazole 500mg IV. Metronidazole 500mg IV/Ampicillin-sulbactam e 3g/Ceftriaxone 2gm. +Metronidazole 500mg/Ertapenem 1gm
SURGICAL ANTIBIOTIC PROPHYLAXIS GENERAL SURGERY* PROCEDURE RECOMMENDED AGENTS a,b Clean None None ALTERNATIVE AGENTS (If allergic to penicillin or colonized/infected with MRSA at any site) Clean with potential
More informationThis is the use of antibiotics before, during and after a diagnostic, therapeutic or surgical procedure to prevent infectious complications.
Antibiotic prophylaxis in surgery CSu2 Policy Antimicrobial prophylaxis is used to reduce the incidence of post operative wound infection; patients undergoing procedures associated with high infection
More informationThe Effect of Perioperative Use of Prophylactic Antibiotics on Surgical Wound Infection
THE IRAQI POSTGRADUATE MEDICAL JOURNAL PROPHYLACTIC ANTIBIOTICS ON SURGICAL WOUND INFECTION The Effect of Perioperative Use of Prophylactic Antibiotics on Surgical Wound Infection Ahmed Hamid Jasim*, Nabeel
More informationMeasure Information Form
Release Notes: Measure Information Form Version 2.0 **NQF-NDORSD VOLUNTRY CONSNSUS STNDRDS FOR HOSPITL CR** Measure Information Form Measure Set: Surgical Care Improvement Project (SCIP) Set Measure ID
More informationNQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE. Measure Information Form Collected For: CMS Voluntary Only
Last Updated: Version 4.4a NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE Measure Infmation Fm Collected F: CMS Voluntary Only Measure Set: Surgical Care Improvement Project (SCIP) Set Measure
More informationMeasure #21 (NQF 0268): Perioperative Care: Selection of Prophylactic Antibiotic First OR Second Generation Cephalosporin
Measure #21 (NQF 0268): Perioperative Care: Selection of Prophylactic Antibiotic First OR Second Generation Cephalosporin 2013 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage
More informationIntra-Abdominal Infections. Jessica Thompson, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Clinical Specialist Renown Health April 19, 2018
Intra-Abdominal Infections Jessica Thompson, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Clinical Specialist Renown Health April 19, 2018 Select guidelines Mazuski JE, et al. The Surgical Infection
More informationChapter Anaerobic infections (individual fields): prevention and treatment of postoperative infections
J Infect Chemother (2011) 17 (Suppl 1):62 66 DOI 10.1007/s10156-010-0141-x GUIDELINES Chapter 2-5-1. Anaerobic infections (individual fields): prevention and treatment of postoperative infections Ó Japanese
More informationNHS Dumfries And Galloway. Surgical Prophylaxis Guidelines
NHS Dumfries And Galloway Surgical Prophylaxis Guidelines The aim of surgical prophylaxis is to reduce rates of surgical site and health-care associated infections and so reduce surgical morbidity and
More informationOBSTETRICS & GYNAECOLOGY. Penicillin G 5 million units IV ; followed by 2.5 million units 4hourly upto delivery
OBSTETRICS & GYNAECOLOGY A.OBSTETRICS Infection/Condition/likely organism Intrapartum Group B Streptococcal (GBS) infection; positive mothers Suggested treatment Preferred Penicillin G 5 million units
More informationAntimicrobial Prophylaxis for Surgical and Non-surgical Procedures
Antimicrobial Prophylaxis for Surgical and Non-surgical Procedures Written by: Dr Linda Jewes, Consultant Microbiologist Date: April 2016 Approved by: Drugs & Therapeutics Committee Date: September 2016
More informationDeveloped by Kathy Wonderly RN, MSEd,CPHQ Developed: October 2009 Most recently updated: December 2014
Developed by Kathy Wonderly RN, MSEd,CPHQ Developed: October 2009 Most recently updated: December 2014 The Center for Medicare and Medicaid (CMS) is moving away from collecting data on the process of care
More informationDepartment of Pharmacy Practice, N.E.T. Pharmacy College, Raichur , Karnataka, India
Bulletin of Pharmaceutical Research 2017;7(1):141 An Official Publication of Association of Pharmacy Professionals ISSN: 2249-6041 (Print); ISSN: 2249-9245 (Online) DOI: 10.21276/bpr.2017.7.1.4 RESEARCH
More informationAntimicrobial Surgical Prophylaxis
Antimicrobial Surgical Prophylaxis The antimicrobial surgical prophylaxis protocol establishes evidence-based standards for surgical prophylaxis at Nebraska Medicine. The protocol was adapted from the
More informationAntimicrobial Surgical Prophylaxis
Antimicrobial Surgical Prophylaxis The antimicrobial surgical prophylaxis protocol establishes evidence-based standards for surgical prophylaxis at The Nebraska Medical Center. The protocol was adapted
More informationAntimicrobial Prophylaxis in the Surgical Patient. M. J. Osgood
Antimicrobial Prophylaxis in the Surgical Patient M. J. Osgood Outline Definitions surgical site infection (SSI) Risk factors Wound classification Microbiology of SSIs Strategies for prevention of SSIs
More informationAntimicrobial Prophylaxis in Digestive Surgery
Antimicrobial Prophylaxis in Digestive Surgery Toar JM. Lalisang, MD, PhD Digestive Surgery Division Cipto Mangunkusumo Hospital Medical Faculty Universitas Indonesia Antibiotic must be present before
More informationSuper Bugs and Wonder Drugs: Protecting the One While Respecting the Many
Super Bugs and Wonder Drugs: Protecting the One While Respecting the Many Vicki Stringfellow, MSN, CPNP-AC/PC Werner Division of Pediatric Critical Care University of Kentucky Lexington, KY Disclosure
More informationRisk of Infection Following Penetrating Abdominal Trauma: A Selective Review
THE YALE JOURNAL OF BIOLOGY AND MEDICINE 59 (1986), 395-401 Risk of Infection Following Penetrating Abdominal Trauma: A Selective Review DANIEL SCOTT RUSH, M.D., AND RONALD LEE NICHOLS, M.D. Department
More informationWho should read this document 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version 3. Policy/Procedure/Guideline 3
Antibiotic Prophylaxis in Cranial Neurosurgery Antibiotic Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): as above Authors Division: DCSS & Tertiary
More informationThe CARI Guidelines Caring for Australians with Renal Impairment. 8. Prophylactic antibiotics for insertion of peritoneal dialysis catheter
8. Prophylactic antibiotics for insertion of peritoneal dialysis catheter Date written: February 2003 Final submission: May 2004 Guidelines (Include recommendations based on level I or II evidence) Antibiotic
More informationSurgical antibiotic prophylaxis: Are you doing it right?
Southern African Journal of Anaesthesia and Analgesia 2018; 24(3)(Supplement 1) Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0
More informationAntibiotic prophylaxis guideline for colorectal, hepatobiliary and vascular surgery for adult patients.
Antibiotic prophylaxis guideline for colorectal, hepatobiliary and vascular surgery for adult patients. Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience,
More informationDuring the second half of the 19th century many operations were developed after anesthesia
Continuing Education Column Surgical Site Infection and Surveillance Tae Jin Lim, MD Department of Surgery, Keimyung University College of Medicine E mail : tjlim@dsmc.or.kr J Korean Med Assoc 2007; 50(10):
More informationPrevention of surgical site infections (SSI) nosocomial infection * - Lead to prolonged hospital stay and increased coasts
Antibiotic Prophylaxis in Surgery Birgit Ross, MD Dep. of Hospital Hygiene University Hospital and Clinics, Essen Prevention of surgical site infections (SSI) - Surgical site infections account for approximately
More informationClinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery
654 ASHP Therapeutic Guidelines Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery These guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP),
More informationSURGICAL ANTIBIOTIC PROPHYLAXIS GUIDELINES WITHIN ORTHOPAEDIC SURGERY FOR ADULT PATIENTS
SURGICAL ANTIBIOTIC PROPHYLAXIS GUIDELINES WITHIN ORTHOPAEDIC SURGERY FOR ADULT PATIENTS Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state if
More informationChildrens Hospital Antibiogram for 2012 (Based on data from 2011)
Childrens Hospital Antibiogram for 2012 (Based on data from 2011) Prepared by: Department of Clinical Microbiology, Health Sciences Centre For further information contact: Andrew Walkty, MD, FRCPC Medical
More informationAn Evidence Based Approach to Antibiotic Prophylaxis in Oral Surgery
An Evidence Based Approach to Antibiotic Prophylaxis in Oral Surgery Nicholas Makhoul DMD. MD. FRCD(C). Dip ABOMS. FACS. Director, Division of Oral and Maxillofacial Surgery Assistant Professor McGill
More informationGeneral Surgery Small Group Activity (Facilitator Notes) Curriculum for Antimicrobial Stewardship
General Surgery Small Group Activity (Facilitator Notes) Curriculum for Antimicrobial Stewardship Facilitator instructions: Read through the facilitator notes and make note of discussion points for each
More informationTreatment of Surgical Site Infection Meeting Quality Statement 6. Prof Peter Wilson University College London Hospitals
Treatment of Surgical Site Infection Meeting Quality Statement 6 Prof Peter Wilson University College London Hospitals TEG Quality Standard 6 Treatment and effective antibiotic prescribing: People with
More informationResponders as percent of overall members in each category: Practice: Adult 490 (49% of 1009 members) 57 (54% of 106 members)
Infectious Diseases Society of America Emerging Infections Network 6/2/10 Report for Query: Perioperative Staphylococcus aureus Screening and Decolonization Overall response rate: 674/1339 (50.3%) physicians
More informationAntimicrobial Selection and Therapy for Equine Musculoskeletal Trauma
Antimicrobial Selection and Therapy for Equine Musculoskeletal Trauma Lucio Petrizzi DVM DECVS Università degli Studi di Teramo Surgical site infections (SSI) Microbial contamination unavoidable Infection
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: Reference Number: CP.HNMC.24 Effective Date: 07.01.17 Last Review Date: 02.18 Line of Business: Medicaid - HNMC Revision Log See Important Reminder at the end of this policy for important
More informationAntimicrobial utilization: Capital Health Region, Alberta
ANTIMICROBIAL STEWARDSHIP Antimicrobial utilization: Capital Health Region, Alberta Regionalization of health care services in Alberta began in 1994. In the Capital Health region, restructuring of seven
More informationEpidemiology and Microbiology of Surgical Wound Infections
JOURNAL OF CLINICAL MICROBIOLOGY, Feb. 2000, p. 918 922 Vol. 38, No. 2 0095-1137/00/$04.00 0 Copyright 2000, American Society for Microbiology. All Rights Reserved. Epidemiology and Microbiology of Surgical
More informationAntibiotic Prophylaxis in Open-Heart Surgery:
Antibiotic Prophylaxis in Open-Heart Surgery: A Comparison of Cefamandole, Cefuroxime, and Cefazolin Layne. Gentry, M.D., Barry J. Zeluff, M.D., and Denton A. Cooley, M.D. ABSTRACT We undertook a prospective
More information1) Mangram AJ,Horan TC,Pearson ML, et al:guideline for Prevention of Surgical Site Infection.Infect Control Hosp Epidemiol 1999;20:247-278. 1a) Perl TM, Cullen JJ, Wenzel RP, et al.: Intranasal mupirocin
More informationClinical Policy: Clindamycin (Cleocin) Reference Number: CP.HNMC.08 Effective Date: Last Review Date: Line of Business: Medicaid - HNMC
Clinical Policy: (Cleocin) Reference Number: CP.HNMC.08 Effective Date: 07.01.17 Last Review Date: 02.18 Line of Business: Medicaid - HNMC Revision Log See Important Reminder at the end of this policy
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: Reference Number: CP.HNMC.04 Effective Date: 07.01.17 Last Review Date: 02.18 Line of Business: Medicaid - HNMC Revision Log See Important Reminder at the end of this policy for important
More informationNeurosurgery Antibiotic Prophylaxis Guideline
Neurosurgery Antibiotic Prophylaxis Guideline Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state if Trust wide): Review date (when this version
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Bennett-Guerrero E, Pappas TN, Koltun WA, et al. Gentamicin
More informationPrevention of Perioperative Surgical Infections
Prevention of Perioperative Surgical Infections Michael A. West, MD, PhD, FACS Department of Surgery University California San Francisco San Francisco, CA, USA Surgical Site Infections (SSI) 2-5% of operated
More informationObjectives. Review basic categories of intra-abdominal infection and their respective treatments. Community acquired intra-abdominal infection
Objectives Review basic categories of intra-abdominal infection and their respective treatments Community acquired intra-abdominal infection Mild/Moderate Severe Acute biliary tract infections Nosocomial
More informationMANAGEMENT OF TOTAL JOINT ARTHROPLASTY INFECTIONS
MANAGEMENT OF TOTAL JOINT ARTHROPLASTY INFECTIONS Paul D. Holtom, MD Professor of Medicine and Orthopaedics USC Keck School of Medicine TOTAL JOINT ARTHROPLASTIES In 2009: 1 million THA and TKA By 2030,
More informationApproach to Antibiotics in Obstetrics: Surgical Prophylaxis for Cesareans
Approach to Antibiotics in Obstetrics: Surgical Prophylaxis for Cesareans Amy Murtha, MD Associate Professor Vice Chair for Research Department of Ob/Gyn Objectives Review antibiotic prophylaxis for
More informationUse And Misuse Of Antibiotics In Neurosurgery
Use And Misuse Of Antibiotics In Neurosurgery CSF infection in the United States after neurosurgery from 1992 to 2003 0.86% to 2.32% * *National Nosocomial Infections Surveillance System: National Nosocomial
More informationGynaecological Surgery in Adults Surgical Antibiotic Prophylaxis
Gynaecological Surgery in Adults Surgical Antibiotic Prophylaxis Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state if Trust wide): Review date
More informationSurgical prophylaxis for Gram +ve & Gram ve infection
Surgical prophylaxis for Gram +ve & Gram ve infection Professor Mark Wilcox Clinical l Director of Microbiology & Pathology Leeds Teaching Hospitals & University of Leeds, UK Heath Protection Agency Surveillance
More informationA Study on Pattern of Using Prophylactic Antibiotics in Caesarean Section
IOSR Journal Of Pharmacy (e)-issn: 2250-3013, (p)-issn: 2319-4219 www.iosrphr.org Volume 5, Issue 1 (January 2015), PP. -12-18 A Study on Pattern of Using Prophylactic Antibiotics in Caesarean Section
More informationnumber Done by Corrected by Doctor
number 28 Done by Dina Yaseen Corrected by حسام أبو عوض Doctor مالك الزحلف Cephalosporins -Cephalosporins are β-lactam antibiotics isolated from a strain of Streptomyces. -They are bactericidal and work
More informationSystemic Antimicrobial Prophylaxis Issues
Systemic Antimicrobial Prophylaxis Issues Pierre Moine Department of Anesthesiology University of Colorado Denver 3 rd International Conference on Surgery and Anesthesia OMICs Group Conference The Surgical
More informationManagement of Native Valve
Management of Native Valve Infective Endocarditis 2005 AHA 2015 Baddour LM, et al. Circulation. 2015;132(15):1435-86 2009 ESC 2015 Habib G, et al. Eur Heart J. 2015;36(44):3075-128 ESC 2015: Endocarditis
More informationSurgical Site Infections (SSIs)
Surgical Site Infections (SSIs) Postoperative infections presenting at any level Incisional superficial (skin, subcutaneous tissue) Incisional deep (fascial plane and muscles) Organ/space related (anatomic
More informationEVALUATION OF SURGICAL ANTIBIOTIC PROPHYLAXIS IN ASEER AREA HOSPITALS IN KINGDOM OF SAUDI ARABIA
www.arpapress.com/volumes/jpcs/vol6/jpcs_6_01.pdf EVALUATION OF SURGICAL ANTIBIOTIC PROPHYLAXIS IN ASEER AREA HOSPITALS IN KINGDOM OF SAUDI ARABIA Mohamed A. Hammad 1, Khaled M. AL-Akhali 2 & Abubakr T.
More information2013 PQRS Measures Groups Specifications Manual PERIOPERATIVE CARE MEASURES GROUP OVERVIEW
PERIOPERATIVE CARE MEASURES GROUP OVERVIEW 2013 PQRS OPTIONS F MEASURES GROUPS: CLAIMS, REGISTRY 2013 PQRS MEASURES IN PERIOPERATIVE CARE MEASURES GROUP: #20. Perioperative Care: Timing of Prophylactic
More informationCurrent Practices of Preoperative Bowel Preparation Among North American Colorectal Surgeons
609 Current Practices of Preoperative Bowel Preparation Among North American Colorectal Surgeons Ronald Lee Nichols, Jeffrey W. Smith, Rena Y. Garcia, From the Department of Surgery, Tulane University
More informationSurgical site infections: Assessing risk factors, outcomes and antimicrobial sensitivity patterns
African Journal of Microbiology Research Vol. 3 (4) pp. 175-179 April, 29 Available online http://www.academicjournals.org/ajmr ISSN 1996-88 29 Academic Journals Full Length Research Paper Surgical site
More informationHyperlink to Guideline
Clinical Guideline Surgical Antibiotic Prophylaxis Sites where Clinical Guideline applies All facilities where surgery is carried out This Clinical Guideline applies to: 1. Adults Yes 2. Children up to
More informationPathogens and Antibiotic Sensitivities in Post- Phacoemulsification Endophthalmitis, Kaiser Permanente, California,
Pathogens and Antibiotic Sensitivities in Post- Phacoemulsification Endophthalmitis, Kaiser Permanente, California, 2007-2012 Geraldine R. Slean, MD, MS 1 ; Neal H. Shorstein, MD 2 ; Liyan Liu, MD, MS
More informationTHERAPY OF ANAEROBIC INFECTIONS LUNG ABSCESS BRAIN ABSCESS
THERAPY OF ANAEROBIC INFECTIONS Douglas Black, Pharm.D. Associate Professor School of Pharmacy University of Washington dblack@u.washington.edu LUNG ABSCESS A lung abscess is a localized pus cavity in
More informationOther Beta - lactam Antibiotics
Other Beta - lactam Antibiotics Assistant Professor Dr. Naza M. Ali Lec 5 8 Nov 2017 Lecture outlines Other beta lactam antibiotics Other inhibitors of cell wall synthesis Other beta-lactam Antibiotics
More informationGeneral Approach to Infectious Diseases
General Approach to Infectious Diseases 2 The pharmacotherapy of infectious diseases is unique. To treat most diseases with drugs, we give drugs that have some desired pharmacologic action at some receptor
More informationAntibiotic Abyss. Discussion Points. MRSA Treatment Guidelines
Antibiotic Abyss Fredrick M. Abrahamian, D.O., FACEP, FIDSA Professor of Medicine UCLA School of Medicine Director of Education Department of Emergency Medicine Olive View-UCLA Medical Center Sylmar, California
More informationThe Microbiology of Postoperative Peritonitis
MAJOR ARTICLE The Microbiology of Postoperative Peritonitis A. Roehrborn, 1 L. Thomas, 2 O. Potreck, 4 C. Ebener, 5 C. Ohmann, 1,3 P. E. Goretzki, 1 and H. D. Röher 1 1 Department of General and Trauma
More informationPrevention of Surgical Site Infections
Prevention of Surgical Site Infections A Review of Recent Evidence and Guidelines Dale W. Bratzler, DO, MPH, MACOI, FIDSA Professor and Associate Dean, College of Public Health Professor, College of Medicine
More informationSecondary peritonitis
Secondary peritonitis Caused by spillage of gastrointestinal microorganisms into the peritoneal cavity secondary to loss of the integrity of the mucosal barriers Etiology: perforation of peptic ulcer traumatic
More informationPRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE
PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE Global Alliance for Infection in Surgery World Society of Emergency Surgery (WSES) and not only!! Aims - 1 Rationalize the risk of antibiotics overuse
More informationGUIDELINE FOR ANTIMICROBIAL USE IN THE ORTHOPAEDIC AND TRAUMA DEPARTMENT
GUIDELINE FOR ANTIMICROBIAL USE IN THE ORTHOPAEDIC AND TRAUMA DEPARTMENT Written by: Dr Ken. N. Agwuh, Consultant Microbiologist Mr Roger Helm, Consultant Orthopaedic Surgeon Mr T Kumar, Consultant Orthopaedic
More informationStanding Orders for the Treatment of Outpatient Peritonitis
Standing Orders for the Treatment of Outpatient Peritonitis 1. Definition of Peritonitis: a. Cloudy effluent. b. WBC > 100 cells/mm3 with >50% polymorphonuclear (PMN) cells with minimum 2 hour dwell. c.
More informationInfective complications according to duration of antibiotic treatment in acute abdomen
International Journal of Infectious Diseases (2004) 8, 155 162 Infective complications according to duration of antibiotic treatment in acute abdomen Ana L.M. Gleisner*, Rodrigo Argenta, Marcelo Pimentel,
More informationNQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE. Measure Information Form Collected For: CMS Voluntary Only
Last Updated: Version 4.4a NQF-ENORSE VOLUNTARY CONSENSUS STANARS FOR HOSPITAL CARE Measure Information Form Collected For: CMS Voluntary Only Measure Set: Surgical Care Improvement Project (SCIP) Set
More informationProc. related Joseph Lister - antiseptic principles Zoutman et al Inf Contr Hosp Epi 1999
Dick Zoutman, MD, FRCPC Queen s University School of Medicine & Kingston General Hospital, Kingston, Ontario, Canada Hosted by Paul Webber paul@webbertraining.com www.webbertraining.com Practical Meaning
More informationAdult Interventional Radiology Prophylaxis Antibiotic Guideline Providence Alaska Medical Center Last Updated: March 2015
Page 1 of 9 Adult Interventional Radiology Prophylaxis Antibiotic Guideline Providence Alaska Medical Center Last Updated: March 2015 Introduction 1 : Antimicrobial prophylaxis prior to Interventional
More informationPocket Guide to Diagnosis & Treatment of Vascular Graft Infections (VGI)
Pocket Guide to Diagsis & Treatment of Vascular Graft Infections (VGI) DEFINITION Investigation /sign Local signs of infection Histopathology Microbiology Definitive Criteria Purulent wound secretion sinus
More informationAntibiotic Updates: Part I
Antibiotic Updates: Part I Fredrick M. Abrahamian, DO, FACEP, FIDSA Health Sciences Clinical Professor of Emergency Medicine David Geffen School of Medicine at UCLA Los Angeles, California Financial Disclosures
More informationOriginal Date: 02/2010 Purpose: To maximize antibiotic stewardship for intraabdominal infection in the Precedes: 4/2013
Division of Acute Care Surgery Clinical Practice Policies, Guidelines, and Algorithms: Antibiotic Therapy: Intra-Abdominal Infections Clinical Practice Algorithm Original Date: 02/2010 Purpose: To maximize
More informationInt.J.Curr.Microbiol.App.Sci (2017) 6(3):
International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 6 Number 3 (2017) pp. 891-895 Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2017.603.104
More informationPatient Preparation. Surgical Team
January 2019 www.nursingcenter.com Surgical Site Infection Prevention Surgical site infections (SSIs) are one of the most common and costly healthcare-associated infections in the United States (Smith
More informationReducing Infections in Surgical Practice. Fred A Sweet, MD Rockford Spine Center Illinois, USA
Reducing Infections in Surgical Practice Fred A Sweet, MD Rockford Spine Center Illinois, USA Introduction: How bacteria get in The Host The Surgeon The Procedure The STAFF Skin PREP Prophylactic Antibiotics
More information3/20/2011. Code 215 of Hammurabi: If a physician performed a major operation on
The Good Antibiotics: the Good, the Bad and the Ugly John P. Cello, MD Professor of Medicine and Surgery, University of California, San Francisco Most organisms can be readily identified by culture, special
More informationAntibiotic Prophylaxis in Adult Orthopaedic Surgery. Formulary/prescribing guideline
Document type: Antibiotic Prophylaxis in Adult Orthopaedic Surgery Version: 2.0 Author (name): Author (designation): Validated by Formulary/prescribing guideline Dr Celia Chu, Dr Katy Edwards, Dr Pradeep
More informationScottish Medicines Consortium
Scottish Medicines Consortium daptomycin 350mg powder for concentrate for solution for infusion (Cubicin ) Chiron Corporation Limited No. (248/06) 10 March 2006 The Scottish Medicines Consortium (SMC)
More informationChapter Anaerobic infections (individual fields): intraperitoneal infections (acute peritonitis, hepatobiliary infections, etc.
J Infect Chemother (2011) 17 (Suppl 1):84 91 DOI 10.1007/s10156-010-0146-5 GUIDELINES Chapter 2-5-4. Anaerobic infections (individual fields): intraperitoneal infections (acute peritonitis, hepatobiliary
More informationThe use of pre- or postoperative antibiotics in surgery for appendicitis: A systematic review
433SJS103110.1177/1457496913497433Use of pre- or postoperative antibiotics for appendicitis K. Daskalakis, et al. SYSTEMATIC REVIEW Scandinavian Journal of Surgery 103: 14 20, 2013 The use of pre- or postoperative
More informationNew Antibiotics for MRSA
New Antibiotics for MRSA Faculty Warren S. Joseph, DPM, FIDSA Consultant, Lower Extremity Infectious Diseases Roxborough Memorial Hospital Philadelphia, Pennsylvania Faculty Disclosure Dr. Joseph: Speaker
More informationAntibiotic Prophylaxis
CLINICAL GUIDELINE Antibiotic Prophylaxis For use in (clinical areas): For use by (staff groups): For use for (patients): Document owner: Status: All clinical areas All clinicians Microbiology Consultants
More informationCentral Nervous System Infections
Central Nervous System Infections Meningitis Treatment Bacterial meningitis is a MEDICAL EMERGENCY. ANTIBIOTICS SHOULD BE STARTED AS SOON AS THE POSSIBILITY OF BACTERIAL MENINGITIS BECOMES EVIDENT, IDEALLY
More information