GOI Guidelines For Surgical Antimicrobial Prophylaxis
In 2016 National Centre For Disease Control, Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India came out with National Treatment Guidelines for Antimicrobial Use in Infectious Diseases.
Following are major recommendation for
Surgical Antimicrobial Prophylaxis :
- To be administered within 1 hr before the surgical incision.
- Single dose is recommended. Consider for second intra-operative dose in prolong surgery based on the choice of antibiotic used for prophylaxis.
- Prophylaxis should not be given beyond surgery duration (except for cardiothoracic surgery, up to 48 hours permissible)
- Choice of the prophylaxis should be based on the local antibiogram.
| SURGERY | MEDICATION |
| Breast | Inj.Cefazolin 2gm or Inj.Cefuroxime 1.5gm IV stat |
| Gastroduodenal & biliary | Inj.Cefaperazone- Sulbactam 2gm IV stat & BD for 24hrs(maximum) |
| ERCP | Inj.Piperacillin-Tazobactum 4.5gm or Inj.Cefaperazone- Sulbactam 2gm IV stat |
| Cardiothoracic | Inj.Cefuroxime 1.5gm IV stat & BD for 48hrs |
| Colonic surgery | Inj.Cefaperazone- Sulbactam 2gm IV stat & BD for 24hrs(maximum) |
| Abdominal surgery (hernia) | Inj.Cefazolin 2gm or Inj.Cefuroxime 1.5gm IV stat |
| Head & Neck/ ENT | Inj.Cefazolin 2gm IV stat |
| Neurosurgery | Inj.Cefazolin 2gm or Inj.Cefuroxime 1.5gm IV stat |
| Obstetrics& Gynecology | Inj.Cefuroxime 1.5gm IV stat |
| Orthopaedic | Inj.Cefuroxime 1.5gm IV stat & BD for 24 hrs(maximum) or Inj.Cefazolin 2gm IV stat Open reduction of closed fracture with internal fixation- Inj.Cefuroxime 1.5gm IV stat and q 12h or Inj.Cefazolin 2gm IV stat and q 12h for 24 hrs |
| Trauma | Inj.Cefuroxime 1.5gm IV stat and q 12h (for 24 hrs) or Inj.Ceftriaxone 2gm IV OD |
| Urologic procedures | Antibiotics only to patients with documented bacteriuria |
| Trans- rectal prostatic surgery | Inj.Cefaperazone- Sulbactam 2gm IV stat |
You can read the full Guideline by clicking on the following link :
http://www.ncdc.gov.in/writereaddata/linkimages/AMR_guideline7001495889.pdf
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