E-drug: 4th generation cephalosporins (cont)
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I fully agree with other advisers: There are 4 types of operation:
(1) clean;
(2) clean-contaminated;
(3) contaminated and
(4) dirty.
The latter one is not prophylaxis, but treatment (guided by type and
resistance infecting microorganism).
Guidelines:
(1) Simple procedures - no prophylaxis; more extended - Single i.v.
dose cefazolin, may be combined with metronidazole (gastrointestinal
and gynaecological surgery);
(2) Various combinations of 2d generation cephalosporin with
gentamicin, no longer than 48 hrs.
(3) when superinfection is suspected a 3d generation cephalosporin
(cefotoxin, cefuroxime).
(4) - like perforated appendix etc. - combined i.v. aminoglycoside +
a cephalosporin, 5-10 days. Avoid all oral cephalosporins and
observe adequate dosing.
So - generally - just one parenteral dose of an "old" and cheap
cephalosporin 30
minutes before the operation.
Good luck.
Dr.L.Offerhaus
Koedijklaan 1a
NL-1406 KW Bussum
The Netherlands
Phone +31-35-6923288 Fax +31-35-6923277
"Dr.L.Offerhaus" <lo@euronet.nl>
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