Prophylactic antibiotics in gut surgery
Wound infections are common following gut surgery, though this risk is substantially reduced with the correct use of prophylactic antibiotics:
- give antibiotics one hour before surgery
- administer IV, IM or as suppositories for metronidazole
- antibiotics can usually be stopped after 24 h
- use antibiotics which are bactericidal against anaerobes and coliforms
Choice of antibiotic may vary according to local preference.
Examples:
- biliary surgery:
- 3 doses of ampicillin 500 mg IV/8 h, or
- cefuroxime 750 mg/8 h IV/IM, or
- tazocin 4500 mg/8 h
- colorectal:
- 3 doses cefuroxime 750 mg/8 h IV/IM, and
- metronidazole 500 mg/8 h IV
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