The Medical Letter on Drugs and Therapeutics
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1495
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Antimicrobial Prophylaxis for Surgery

Antimicrobial prophylaxis can decrease the incidence of postoperative surgical site infection after some procedures. Since the last Medical Letter article on this subject, consensus guidelines have been published.1 Recommendations for prophylaxis in specific surgical procedures are listed in Table 1.

CHOICE OF AGENT — Antimicrobial prophylaxis for surgery should be directed against the most likely infecting organisms, but it does not need to eradicate every potential pathogen to be effective. Cefazolin (Ancef, and others), a first-generation cephalosporin active against many staphylococci and streptococci, can be used for most procedures.

The second-generation cephalosporins cefoxitin (Mefoxin, and others) and cefotetan (Cefotan, and others) are recommended for procedures that involve exposure to bowel flora, including ... more      

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