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Chapter 85. Antimicrobial Prophylaxis in Surgery

Student Questions

Which of the following should not be factored into selection of a surgical prophylaxis agent?

A. Type of surgical procedure

B. Patient's weight

C. Antimicrobial spectrum

D. Surgical site infection rate of the facility

Answer: D

Option A: Type of surgical procedure will dictate the antimicrobial spectrum needed.

Option B: Patient's weight is needed to ensure appropriate dosing based on pharmacokinetic/pharmacodynamics data

Option C: Antimicrobial spectrum will dictate what antimicrobial is required based on most likely causative organisms.

Option D: The facility rate of surgical site infection would not exclude a patient from receiving surgical site prophylaxis or require broader spectrum of antimicrobials.

Which of the following statements is true?

A. All antimicrobials should be infused 2 hours prior to first incision.

B. Most surgical site infections are caused by S. aureus.

C. Surgical prophylaxis should be continued for at least 48 hours.

D. Surgery length does not dictate the need for additional antimicrobial doses

Answer: B

Option A: Antimicrobial should be infused within 1 hour prior to incision, with vancomycin and levofloxacin being exceptions due to required infusion times.

Option B: Most surgical site infections are caused by Staphylococcus species.

Option C: Current guidelines recommend duration of surgical prophylaxis to be no longer than 24 hours, except in cardiac surgeries which may be extended to 48 hours

Option D: The length of surgery and half-life of the antimicrobial use may necessitate redosing of antimicrobials during surgery.

Which of the following is guideline recommended routes of administration for antimicrobial prophylaxis?

A. Topical irrigation

B. Intravenous

C. Oral

D. B and C

Answer: D

Option A: Intravenous is recommended for all surgical procedures.

Option B: The role of application of antimicrobials via topical irrigation has not been well-defined and is currently not endorsed in the guidelines as a preferred route.

Option C: Oral antimicrobial prophylaxis is recommended for colorectal procedures.

Option D: Intravenous is recommended for all surgical procedures. Oral antimicrobial prophylaxis is recommended for colorectal ...

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