Autologous breast reconstruction

  • deep inferior epigastric perforators (DIEP) flap
  • transverse rectus-abdominus myocutaneous (TRAM) flap

Common Pathogens

S. aureus
Coagulase negative Staphylococcus (CoNS)
Streptococcus 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 MRSA colonization/past infection, add:
Vancomycin 15mg/kg 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])
Vancomycin 15mg/kg IV x 1 pre-op dose
or    
Clindamycin 600mg IV x 1 pre-op dose