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Guidelines
Pathogens
Antimicrobials
≤ 24 hours post-op
Cefazolin 2g IV Q8H
If gastric acid suppression or malignancy
ADD
Metronidazole 500mg IV Q12H
Therapy Pearls
Cefazolin 3g is used peri-op for ≥ 120kgs
1g doses of Cefazolin are not recommended for gram-negative infections due to rising MICs of bacteria like E. coli
If perforation is due to H. pylori associated ulcer
Subsequent treatment of H pylori
Gentamicin 120mg IV 30 min PRE-OP
AND
Clindamycin 600mg IV 30 min PRE-OP
