Surgical Infection Prophylaxis Flashcards


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1

What is the 1st line agent for prophylaxis especially for clean surgeries?

Cefazolin 1-2 grams x 1

2

Which agent should be used for colorectal surgery prophylaxis when broader gram negative and anaerobic coverage is needed?

Cefoxitin 1g x 1

3

Which agent should be used is risk of nosocomial MRSA is low and the patient has a type-1 beta lactic allergy?

Clindamycin 600 mg x 1

4

What are some risk factors for surgical infections?

Poorly controlled diabetes

Preoperative smoking

Preoperative immunosuppression

HIV or Hep C

Malnutrition

5

What is the only indication to use Vanc for surgical infections?

Colonization of nares with s. aureus

6

Class I SSI:

Clean

Antibiotics not indicated unless high risk (prosthetic)

7

Class II SSI:

Clean/contaminated

Prophylaxis indicated

8

Class III SSI:

Contaminated

Prophylaxis indicated

9

Class IV SSI:

Dirty/contaminated

Therapeutic antibiotics required

10

Antibiotic administration should be completed within how many minutes prior to initial incision?

60 minutes

11

What would happen if ABs are given too early?

AB concentrations may drop below the organisms MIC towards the end of the operation

12

What would happen if ABs are given too late?

The patient will be unprotected at the time of the initial incision

13

In which situation should ABs be re-dosed inta-operatively?

If the surgery last longer than two-half lives for the chosen AB

14

What duration of surgery would warrant reducing of cefazolin?

4 hours (t1/2=2 hours)

15

AB prophylaxis is always warranted with Gastroduodenal surgeries?

False

Clean procedure

Only high-risk populations should receive prophylaxis

16

Gastroduodenal surgery prophylaxis:

1st line: IV cefazolin

Alternative: oral ciprofloxacin

17

High risk populations that should receive prophylaxis for GD procedures?

Obstruction

Hemorrhage

GI malignancy

Concomitant acid suppression therapy

18

Risk of SSI is high due to significant bacterial counts in fecal matter present in the colon?

True

19

Colorectal surgery prophylaxis:

1. Cefoxitin

2. Cefotetan

20

If cefazolin is used for Colorectal surgery prophylaxis, what agent should be added on?

Flagyl

21

Alternative treatment of Colorectal surgery prophylaxis is beta-lactam allergy?

Gentamicin

22

What is the most frequently encountered organism in high risk GU procedures?

E. coli

23

GU prophylaxis:

Preferred: PO Cipro or Bactrim DS x 1

Alternative: IV cefazolin

24

Why is prophylaxis given in c-sections?

To prevent endometritis

25

C-section prophylaxis:

Cefazolin 2 grams x 1

26

Cardiac surgeries have low risk of SSI?

True- but have high morbidity of SSI

27

Cardia surgery prophylaxis:

Cefazolin 1g x 1

2 g if >80 kg

redone for long procedures

28

Thoracic surgery prophylaxis:

Cefuroxime 750 mg IV q 8 h x 48 hours

29

What two organisms are common in CSF shunts?

S. aureus and s. epidermis

30

CSF shunt prophylaxis:

Cefazolin 1 g IV q 8h for 24 hours

31

Joint replacement/ Hip fractures repair/ Open/ Compound Fractures prophylaxis:

Cefazolin 1 g IV q 8h for 24 hours

32

What dose should be given to patients with BMI >40

2 gram

33

How often should cefazolin be doses for patients with renal dysfunction

q8 hours

34

Burns/spinal cord injuries require more frequent intraoperative dosing for beta-lactams and aminoglycosides?

True

35

What must HC personnel wear for contact precautions?

Gown and gloves

36

What must HC personnel wear for droplet precautions?

Mask

Eye protection

gown and gloves

37

What must HC personnel wear for airborne precautions?

N95 mask

eye protection

gown and gloves

38

Examples of contact precautions:

MDR organisms/diarrhea

MRSA

VRE

ESBLs

KPC

C. diff

Norovirus

HSV

39

Examples of droplet precautions:

Cough

Influenza, pneumoniae, pertussis, Pneumonic plaque (Yersinia pestis), adenovirus

40

Examples of airborne precautions:

Tuberculosis, Shingles, Varicella (chickenpox) measles, COV1, and COV2