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Use of Antibiotics?

Chapter 11: Table of Contents

Use of Antibiotics?

Gastric and intestinal surgery results in a clean-contaminated or contaminated procedures depending on spillage. Patients with foreign bodies are also at risk for intestinal bacterial overgrowth due to the obstruction. I administer perioperative antibiotics (first dose at induction and every 90 minutes during the procedure if applicable) in all patients with foreign bodies. In theory, cefazolin (1st generation cephalosporin) is indicated for surgery of the stomach and proximal intestine and cefoxitin (2nd generation) is indicated for surgery of the lower small intestine and colon. My antibiotic of choice is cefoxitin (2nd generation cefalosporin) – you never know what you will find! I administer antibiotics for a maximum of 24 hours unless severe contamination (peritonitis) is present in which case I give a full course but change the antibiotic if necessary once the bacterial culture results are available.


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