Infectious Diseases II
Type of Surgery
Recommended Prophylaxis
Alternative Prophylaxis in Patients
with ฮฒ-Lactam Allergies
Coronary artery bypass grafting
Other cardiac surgery
Vascular surgery
Hip arthroplasty
Knee arthroplasty
Neurosurgery
Cefazolin
Cefuroxime
Vancomycin
Clindamycin
Thoracic surgery
Cefazolin
Ampicillin/sulbactam
Vancomycin
Clindamycin
Gastroduodenal surgery
Cefazolin
Clindamycin or vancomycin +
aminoglycoside or fluoroquinolone or
aztreonam
Colorectal surgery
Cefotetan or cefoxitin or ampicillin/
sulbactam or ertapenem
Metronidazole + cefazolin or
cefuroxime or ceftriaxone
Clindamycin + aminoglycoside or
fluoroquinolone or aztreonam
Metronidazole + aminoglycoside or
fluoroquinolone
Abdominal hysterectomy
Vaginal hysterectomy
Biliary tract surgery
Cefotetan or cefoxitin or ampicillin/
sulbactam
Clindamycin or vancomycin +
aminoglycoside or fluoroquinolone or
aztreonam
Metronidazole + aminoglycoside or
fluoroquinolone
Antimicrobial
Recommended Dose in Adults
Dosing Interval (hr)a
Ampicillin/sulbactam
3 g
Ampicillin
2 g
Aztreonam
2 g
Cefazolin
2 g, 3 g for patients weighing โฅ 120 kg
Cefuroxime
1.5 g
Cefoxitin
2 g
Cefotetan
2 g
Ceftriaxone
2 g
N/Ab
Ciprofloxacin
400 mg
N/Ab
Clindamycin
900 mg
Ertapenem
1 g
N/Ab
Gentamicin
5 mg/kg of ideal or adjusted body weightc
N/Ab
Levofloxacin
500 mg
N/Ab
Metronidazole
500 mg
N/Ab
Vancomycin
15 mg/kg
N/Ab
aWith presumed normal renal function and dose as needed
bOne dose of the antibiotic should suffice for the duration of most surgical procedures.
cUse adjusted body weight if actual body weight is > 20% of ideal body weight (IBW). Adjusted body weight = IBW + 0.4 (actual weight โ IBW).
N/A = not applicable.