Traumatic/crush hand injuries
Common Pathogens
S. aureus
Streptococcus spp
Enterobacteriaceae
Anaerobes
Regimen(s) of Choice See General Principles and Pre-Op Antibiotic Administration and Intraoperative Antibiotic Administration | ||
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Cefazolin | 2g IV | x 1 pre-op dose |
If MRSA colonization/past infection and use of prosthetic material, 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]) | ||
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Clindamycin | 600mg IV | x 1 pre-op dose |
or | ||
Vancomycin | 15mg/kg IV | x 1 pre-op dose |
If heavily soiled/contaminated, consider adding: | ||
Gentamicin | 5mg/kg IV | x 1 pre-op dose to above regimens |