Pelvic Surgical Site Infections in Gynecologic Surgery

Table 2

Recommended doses and redosing intervals for commonly used antimicrobials for surgical prophylaxis for gynecological procedures^[a].

Antimicrobial	Recommended dose	Half-life (hours)	Recommended redosing interval (hours)^[b]
Ampicillin-sulbactam	3 g (ampicillin 2 g/sulbactam 1 g)	0.8–1.3	2
Aztreonam	2 g	1.3–2.4	4
Cefazolin	2 g, 3 g for pts weighing ≥120 kg	1.2–2.2	4
Cefuroxime	1.5 g	1-2	4
Cefoxitin	2 g	0.7–1.1	2
Cefotetan	2 g	2.8–4.6	6
Ciprofloxacin	400 mg	3–7	NA
Clindamycin	900 mg	2–4	6
Gentamicin	5 mg/kg based on dosing weight (single dose)^[c]	2-3	NA
Levofloxacin	500 mg	6–8	NA
Metronidazole	500 mg	6–8	NA

Adapted from [25].
^[a]Dosing and redosing interval for adult patients with normal renal function.
^[b]Redosing in the operating room is recommended at an interval of approximately two times the half-life of the agent in patients with normal renal function. Recommended redosing intervals marked as “not applicable” (NA) are based on typical case length; for unusually long procedures, redosing may be needed.
^[c]ln general, gentamicin for surgical antibiotic prophylaxis should be limited to a single dose given preoperatively. Dosing is based on the patient’s actual body weight. If the patient’s actual weight is more than 20% above ideal body weight (IBW), the dosing weight (DW) can be determined as follows: DW = IBW + 0.4(actual weight − IBW).