prophylactic antibiotics in gut surgery

Last reviewed 01/2018

Wound infections are common following gut surgery, though this risk is substantially reduced with the correct use of prophylactic antibiotics:

  • give antibiotics one hour before surgery
  • administer IV, IM or as suppositories for metronidazole
  • antibiotics can usually be stopped after 24 h
  • use antibiotics which are bactericidal against anaerobes and coliforms

Choice of antibiotic may vary according to local preference.

Examples:

  • biliary surgery:
    • 3 doses of ampicillin 500 mg IV/8 h, or
    • cefuroxime 750 mg/8 h IV/IM, or
    • tazocin 4500 mg/8 h

  • colorectal:
    • 3 doses cefuroxime 750 mg/8 h IV/IM, and
    • metronidazole 500 mg/8 h IV