Adult Guidelines
Pre-Incisional Antimicrobial Recommendations - Adult

Pre-Incisional Antimicrobial Recommendations - Adult

Antibiotic Timing and Duration

All antimicrobials should be administered within 1 hour prior to incision, unless otherwise indicated

  • Only 1 dose of antibiotics recommended for clean/clean contaminated procedures, unless the duration of surgery exceeds the recommended re-dosing interval
    • Intra-operative re-dosing intervals assume normal renal function, call pharmacy if patient has impaired renal function
  • Total duration of antibiotics not to exceed 24-hours post-op

Antibiotic Surgical Prophylaxis in Patients with Penicillin Allergies

Note: cefazolin does not share any side chains with any other beta-lactam antibiotic. 

When used for surgical prophylaxis, cefazolin is more effective and associated with fewer adverse effects compared to non-beta-lactams

Questions Regarding the Choice of Antimicrobial Prophylaxis?

For questions regarding choice of antimicrobial surgical prophylaxis, contact the Antimicrobial Stewardship Program

Additional Information

Please call pharmacy for patients with impaired renal function to assist with antimicrobial dosing

Patients on Systemic Antibiotics for Other Indications

Surgical prophylaxis should still be administered pre-incision, unless systemic antibiotics are given in the prior 60 minutes (120 minutes if vancomycin) and have an otherwise appropriate spectrum of activity for prevention of surgical site infections.

Patients with Blood Loss or Severe Burns

  • Regardless of previous dose timing, consider immediate antibiotic re-dosing for > 1.5 L of blood loss (> 25 mL/kg or > 30% blood volume loss for patients < 40 kg) within a short time frame and in those with severe burns
  • Do not re-dose vancomycin or gentamicin
  • Restart re-dosing clock if repeat antibiotic dose given for blood loss