antibiotics ????

[justanurse]

When I used to be in orthopaedics, 99% of the patients were put on antibiotics after orthopaedic surgery. Has the trend changed in the last few years? Are the big teaching hospitals doing anything different than the smaller hospitals?

Thanks for your time and input!!!!!

[GJBOUSHLEY]

I work in Wisconsin and our MD's currently put patients on IV Ancef or Zinacef 1 dose pre-op and 3 doses post-op for total joint replacements most other ortho cases recieve an IV dose pre-op only.

[justanurse]

Thanks for the reply. How about patients who received a fracture as a result of a trauma? Do your physicians generally cover those patients with increased doses of antibiotics?

Thanks again!!!

[kewlnurse]

Our patiens get ancef 1 g iv x 6 doses, joints and spines, orif's usually get it for 3 doses, fractures usually don't get anything

[JillRN]

I work on a busy Ortho unit in a large teaching hospital. In our total joint program and with most ortho surgeries our patients receive one dose of Ancef 1 G pre-op and usually three doses post-op. If allergic to PCN, Clindamycin is substituted.

[looshy]

It can be given parenterally (trade name Zinacef) or orally by tablets and zinacef is indicated for infections of the lungs or throat or ears or urinary tract!!

[mcmike55]

Antibiotic therapy guidlines have changed quite a lot in the past few years.

According to National Patient Safety Guidelines, antibiotics are to be started within 60 minutes of incision, and d/c'ed within 24 hours.

We usually use Ancef, Clindamycin or Vanco if PCN allergy.

Open fractures, I'm not sure how that's handled, I'm just with the pt in the OR. I suspect it depends on the situation, clinical picture, and culture results.

check the Joint Commissions' website, it's all there.

mike