Guidelines
Preferred Pre-op Antibiotics

Preferred Pre-op Antibiotics

General Information

Please contact the OR Satellite with any questions at 22250

These recommendations are a general guideline for Pharmacy to be used when the preoperative antibiotic selected by the physician does not meet clinical practice guidelines for antimicrobial prophylaxis in surgery guidelines.

Routine weight-based dosage adjustment will be done on all preoperative antibiotic orders for beta-lactams, vancomycin and aminoglycosides.

When using vancomycin for suspected MRSA, a comment must be made to the order indicating the vancomycin is appropriate based on SMMC antibiogram data.

Cefazolin to be used for all allergies except cefazolin allergy.

  • Based on recent data, cefazolin has no like side chains to other beta-lactams and has low risk for cross allergy.
  • This position has been supported by local and corporate committees. For cefazolin allergic patients, vancomycin is the agent of choice.
  • Clindamycin should not used due to concerns for resistance and increased risk for Clostridium difficile infection.
  1. Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013 Feb 1;70(3):195-283.
  2. Inpatient Core Measure Specs 4.2b 1-1-13 to 12-31-13, Measure Set: Surgical Care Improvement Project (SCIP), Set Measure ID: SCIP-Inf-2 SCIP-2-5 to 2-6.
  3. Adventist Health System. Cephalosporin Use in Penicillin Allergic Patients Position Statement. 2015

Last Updated: 11/18/2020