Friday, February 19, 2010

Antibiotic AHD

Pre-op Antibiotics:
- Ancef - for procedures not involving distal ileum, appendix, or colon (alt clinda + gent)
- for colon/

medical post article for antibiotic recommendations

- ancef provides gram positive prophylaxis, some gram neg coverage (but not great)
- for prophylaxis don't need to kill all bacteria

Colorectal prophylaxis
Ancef& Flagyl
If allergy
- clinda & Cipro or Gent and Flagyl
- cipro or gent & flagyl

SSI treatment:
Mild-Moderate community acquired infection ((SSI)
- Cefzaolin/flagyl
- ceftriaxone/flagyl
-cipro/levo and flagyl
-cefoxitin
-Moxifloxacin
Do NOt need enterococcal coverage, candida coverage, aminoglycocides

Severe community acquired infection:
- meropenem
-piptazo
-cipro/levo and flagyl
- ??

Healthcare associated intraabdo infections:
- meropenem/imipenem/doripenem
-piptazo
- ??

When do you need antifungal treatment:
- C. albicans - fluc
- other spp. - need caspofungin
- treat if you grow out of wound

anti-enteroccal
- if you grow from healthcare related infection
- amp, piptazo, or vancomycin

Appendix abx:
- with adequate source control, no need to extend abx beyond 4-7 days

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