Hysterectomy

  • abdominal

  • laparoscopic

  • vaginal

Note: Treat bacterial vaginosis pre-operatively if present. If found incidentally at time of surgery, treat immediately intra-op and for 4 days post-operatively.

 

Common Pathogens

Enterobacteriaceae
Anaerobes
Group B Streptococci
Enterococcus 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
+/-    
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])
Gentamicin 1.5mg/kg IV x 1 pre-op dose
+    
Clindamycin 600mg IV x 1 pre-op dose