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INFECTION PREVENTION
Begin administration of vancomycin and fluoroquinolone within 120 minutes of
the surgical incision; prolonged
infusion times are required for
these drugs.
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FROM THE CDC
Infections and Effects
The CDC estimates that
• more than 2 surgical site infections occur for every 100 procedures,
• these SSIs are responsible for
nearly 10% of deaths caused by
hospital-acquired infections in
the U.S., and
• each adds $10,000 to $25,000 to
the cost of care per patient
affected.
While the dosing of pediatric
patients is based on weight,
the dosing of most antimicrobials
in adults isn't, because it's safe,
effective and convenient to use
standardized doses. Exceptions,
such as aminoglycosides, should
be evaluated, but the new guidelines state that "when used as a single
dose for prophylaxis, the risk of toxicity from gentamicin is very low."
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For patients weighing more than 264 lbs., you should be using
the new standard recommended doses: 3g cephazolin (compared with 2g for adults under that threshold).
5
The American Society for Gastrointestinal Endoscopy no longer
considers any gastrointestinal procedure high risk for bacterial
endocarditis, and you therefore needn't routinely use endocarditis prophylaxis, even in patients with the highest-risk cardiac conditions (such
as prosthetic valves or prior endocarditis).
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For the common antibiotics used in outpatient surgery — cefazolin, gentamicin, ampicillin, vancomycin and ciprofloxacin —
regularly review the recommendations of a nursing implications text,
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J U N E 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E
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