Surgery- Pediatric



|Surgery- Pediatric |Antibiotic* | |Surgery- Pediatric (cont.) |Antibiotic* |

|Cardiac |3 | |Surgery- Neonates |1 plus 8 |

|Colorectal or Appendectomy |4 or [6 and 7 (+/- 1)] | | | |

|GI esophageal and gastroduodenal (for high risk patients) |3 | | | |

|GI (ruptured viscus) |4 or ( 6 and 7) | | | |

|GU |1 plus 7 | |Surgery-Adult |Antibiotic |

|Orthopedic |3 | |Endocarditis (SBE) Prophylaxis |See SBE Order Set |

|Thoracic (Cardiac) |3 | | | |

|Thoracic (Non-Cardiac) |3 | | | |

|Traumatic Wound |3 | |MRSA Suspected or Confirmed* |9 |

|Traumatic Wound (bite) |2 | |Beta-Lactam (Penicillin) Allergy |9 or 6 |

* Vancomycin (usually in addition to other antibiotics such as cefazolin) should be considered in patients known to be previously colonized or infected

with MRSA. It is used (without cefazolin) in those allergic to penicillins or cephalosporins.

Prophylactic Antibiotic Choices

|1 |Ampicillin |50 mg/kg/dose IV |repeat intraoperatively in 4 hours |Max 2000 mg |

|2 |Ampicillin/Sulbactam |50 mg/kg/dose IV |repeat intraoperatively in 4 hrs |Max 2000 mg |

|3 |Cefazolin |25 mg/kg/dose IV |repeat intraoperatively in 4 hrs |Max 2000 mg |

|4 |Cefoxitin |40 mg/kg/dose IV |repeat intraoperatively in 4 hrs |Max 2000 mg |

|5 |Ceftriaxone |50 mg/kg/dose IV |repeat intraoperatively in 12 hrs |Max 2000 mg |

|6 |Clindamycin |10 mg/kg/dose IV |repeat intraoperatively in 6 hrs |Max 900 mg |

|7 |Gentamicin†‡ |2 mg/kg/dose IV |repeat intraoperatively in 8 hrs |Max 120 mg |

|8 |Gentamicin†§ |3 mg/kg/dose IV |NO second dose is recommended |Max 120 mg |

|9 |Vancomycin†‡ ** | |

|1. Prosthetic cardiac valves, including |1. Most other congenital heart malformations |1. Isolated secundum ASD                               |

|bioprosthetic and homograft valves |2. Acquired valvular dysfunction (e.g. ARF) |2. Surgical repair of ASD, VSD or PDA (without residua and beyond 6 |

|2. Previous bacterial endocarditis |3. Hypertrophic cardiomyopathy |mo of age) |

|3. Complex cyanotic congenital heart disease |4. Mitral valve prolapse with valvular |3 .Previous coronary artery bypass surgery |

|4. Surgically constructed systemic pulmonary shunts or |regurgitation or thickened leaflets |4. Mitral valve prolapse with no dysfunction |

|conduits |                                   |5. Previous ARF with no valve dysfunction |

|                                   | |6. Cardiac pacemakers and implanted defibrillators |

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