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GYN SURGERY: PREOPERATIVE CONSIDERATIONS

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Antibiotic Prophylaxis for Gynecologic Procedures

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  • Antimicrobial Prophylactic Regimens by Procedure (Table 2-1)

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TABLE 2-1

ANTIMICROBIAL PROPHYLACTIC REGIMENS BY PROCEDURE

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Key Points to Remember
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  • Antibiotics must be given within 1 hour prior to skin incision. Anesthesia induction is a convenient time

  • Give repeat dose of antibiotic if

    • Long procedure (over one to two times antibiotics half-life; ex: re-dose cefazolin at 3 hours)

    • EBL over 1500 cc

  • Neither treatment for several days before a procedure nor subsequent doses after procedure are indicated for prophylaxis

  • Prophylactic antibiotics are recommended for induced abortion/dilation and curettage (D&C) even if negative gonorrhea/chlamydia (GC/CT) testing

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Endocarditis Prophylaxis

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  • Cardiac conditions associated with the highest risk of adverse outcomes from endocarditis that require antibiotic prophylaxis are shown in Table 2-2. Suggested antibiotics are listed in Table 2-3

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TABLE 2-2

CARDIAC CONDITIONS REQUIRING ENDOCARDITIS PROPHYLAXIS

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