Amputation of lower limb

Common Pathogens

S. aureus
Coagulase negative Staphylococcus (CoNS)
Enterobacteriaceae
Clostridium spp


Regimen(s) of Choice
See General Principles and Pre-Op Antibiotic Administration and Intraoperative Antibiotic Administration
Cefazolin 2g IV x 1 pre-op dose
If ischemic limb, add:
Metronidazole 500mg IV x 1 pre-op dose

Alternative Regimens if allergy to cefazolin, or severe non-IgE-mediated reaction to any β-lactam (interstitial nephritis, hepatitis, hemolytic anemia, serum sickness, severe cutaneous reactions [e.g. SJS, TEN, DRESS])
Clindamycin 600mg IV x 1 pre-op dose
+    
Gentamicin 1.5mg/kg IV x 1 pre-op dose