The document discusses the timing of administering prophylactic antibiotics before surgery. The first dose should be given within 60 minutes before incision for most surgeries, and within 120 minutes for fluoroquinolones or vancomycin. For cardiothoracic surgery specifically, antibiotics are recommended for up to 72 hours to prevent deep sternal infections.
4. Adapted with permission from Bratzler DW, Houck PM. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis 2004,38:1707. Nir Hus Surgery Prophylaxis Comments Cardiothoracic Cefazolin or cefuroxime; if beta lactam allergy, vancomycin or clindamycin 72-hour duration advocated by some, but 24 hours is likely to be adequate Vascular Cefazolin or cefuroxime; if beta lactam allergy, vancomycin with or without gentamicin, or clindamycin Colon Oral: neomycin, with erythromycin base or metronidazole Combination of oral and parenteral prophylaxis may decrease infection rates