King Abdulaziz University Hospital surgical prophylaxis guidelines
| Operation | Antibiotic prophylaxis | Antibiotic |
|---|---|---|
| Upper gastrointestinal (esophagus, stomach and small bowel) | Recommended | Cefazolin,* 1–2 g or Clindamycin,† 600 mg + gentamicin, 120 mg intravenously |
| Hepatobiliary | ||
| Bile duct, pancreatic, liver and open gallbladder | Recommended | Cefazolin,* 1–2 g or Clindamycin,† 600 mg + gentamicin, 120 mg intravenously |
| Laparoscopic cholecystectomy | Not recommended; should be considered in patients at high risk | Cefazolin,* 1–2 g or Clindamycin,† 600 mg + gentamicin, 120 mg intravenously |
| Lower gastrointestinal (appendix and colorectum) | Highly recommended | Cefoxitin, 1–2 g intravenously every 6 h preoperatively for 3 doses or Cefazolin,* 1–2 g intravenously + metronidazole, 500 mg intravenously |
| Hernia repair, groin (inguinal/femoral with or without mesh, laparoscopic or incisional | Not recommended | — |
↵* A dose of 2 g of cefazolin is recommended for patients weighing more than 80 kg. Dosing cefazolin for renal impairment: creatine clearance 35–54 mL/min: administer full dose in intervals of ≥ 8 hours; creatine clearance 11–34 mL/min: administer half of usual dose every 12 hours; creatine clearance ≤ 10 mL/min: administer half of usual dose every 18–24 hours.
↵† No dosage adjustment required for renal impairment.