Anesthesia/Sedation Preoperative Care and Preparation Clinical Pathway, Inpatient and Emergency Department – Antibiotic Prophylaxis

Anesthesia/Sedation Preoperative Care and Preparation Clinical Pathway, Inpatient and Emergency Department

Perioperative Antibiotic Prophylaxis

  • Complete first dose of preoperative antibiotics by bolus or intravenous infusion no earlier than 60 minutes before incision.
  • If Vancomycin required, see special considerations.
  • For CHOP N/IICU only: Order all antibiotics to the N/IICU and send them with child to the OR.
General Information Perioperative Antibiotic Prophylaxis Guidelines
Perioperative Recommendations Antibiotic Prophylaxis by Surgical Procedure
Non-OR Procedural Units
IR
Cath Lab
 Antibiotic Prophylaxis for Non-operating Room Procedural Units
Dosing Recommendations Dosing for Perioperative Prophylactic Antibiotic Therapy
Receiving Antibiotic Treatment (e.g., Not Prophylaxis) to Continue Through Surgical Procedure
  • Antibiotic regimen covers likely surgical site infection pathogens. Contact Antimicrobial Stewardship or Infectious Diseases with questions.
  • Maintain dosing intervals throughout the procedure.
  • Do not give an additional dose of scheduled antibiotics before incision to prevent overdosing.
Postoperative Antibiotics
  • Antibiotic prophylaxis after wound closure is rarely indicated
    (See Postoperative Antibiotic Prophylaxis)
  • If continuing antibiotics post-op, order and time (or re-time) from last dose given in the OR and continue for no more than 24 hrs for most procedures

Subacute Bacterial Endocarditis (SBE) Prophylaxis

CHOP Recommendations for Pre-procedural Antibiotic Prophylaxis for Subacute Bacterial Endocarditis (SBE)

Vancomycin Special Considerations

Vancomycin  

Indicated if history of colonization or infection with methicillin-resistant Staphylococcus aureus (MRSA)
  • Order vancomycin the day before procedure so that it arrives at inpatient unit before transfer to OR
  • Coordinate timing of Vancomycin administration:
    • Transferring to PACU: PACU charge nurse
    • Direct to OR: OR charge nurse
  • Review nursing administration and implications.
  • Order pre-medication if history of vancomycin infusion reaction.