title: Antimicrobial prophylaxis in general surgery.
abstract: When used appropriately, antimicrobial prophylaxis is highly beneficial and cost effective. Antibiotics are not indicated for "clean procedures" such as hernia and breast surgery. A single preoperative dose will suffice, followed by an intraoperative dose if the operation takes more than 3 hours. For vascular (prosthesis or groin wound), head and neck (pharynx entered), thoracic (gastrointestinal or respiratory entrance) and high-risk gastroduodenal and biliary procedures, cefazolin, 1 g intravenously, is indicated. For procedures involving small intestine, appendix or penetrating abdominal trauma, cefoxitin or cefotetan, 2 g intravenously, is indicated. For colorectal procedures, either oral neomycin plus erythromycin or intravenous aminoglycoside plus clindamycin (or metronidazole) are effective. If valvular heart disease is present, endocarditis prophylaxis should be administered.
authors.affiliation: Department of Surgery, Wellesley Hospital, University of Toronto, Ont.
authors.forename: J M
authors.initials: JM
authors.lastname: Bohnen
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000517:prevention & control*; D006801:Humans; D011292:Premedication; D013514:Surgical Procedures, Operative / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents