Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

GI:Appendectomy 3Anaerobic organisms(especially B fragilis) andGram-negative entericorganisms(predominantly E coli).Staphylococcus,Enterococcus andPseudomonas specieshave also been reported.Uncomplicated:• Cefoxitin 4 1 g IV pre-op(2 g if > 80 kg)Complicated:• Unasyn®(ampicillin/sulbactam)1.5-3 g IV pre-opUncomplicated:• Cefoxitin 30mg/kg IV(Maximum of 2 g) preopComplicated:• Unasyn(ampicillin/sulbactam)37.5mg/kg (provides25mg/kg of ampicillin) IV(Maximum of 3 g) preop• Cefoxitin every 3hours• Unasyn® every 4hoursThe incidence of infectiouscomplications followingappendectomy is dependent onthe condition of the appendix atthe time of surgeryGynecologicLIKELYPATHOGENSANTIMICROBIAL REGIMEN(Adult)ANTIMICROBIAL REGIMEN(Pediatric)OR REDOSINGCOMMENTSLactobacillus sp.Staph aureusCorynebacterium sp.Gram-negativeorganismsAnaerobes• Cefazolin 4 2 g IV---- OrCefoxitin 4 2 g IV---- Or• Clindamycin 900 mg Q8H IVplus gentamicin 1.7 mg/kgIV 30 min pre-op forpenicillin-allergic patients• Cefazolin 25mg/kg IV preop(Maximum of 1 g)---- Or• Cefoxitin 30mg/kg IV(Maximum of 2 g) preop---- Or• Clindamycin 10mg/kg IV(Maximum of 900mg) plusgentamicin 2mg/kg IV(Maximum of 80mg) preopfor penicillin-allergic patients• Cefazolin every 4hours• Cefoxitin every 3hours• Clindamycin every 6hours