Cefazolin 1 gm IV 30 min. Bacteria isolated from bile during surgery are those most likely to be associated with wound infections. Also E. coli, enterococcus and candida in high risk patients. Cefazolin 1 gm IV 30 min. Prophylaxis indicated only for patients with increased pH from the use of H 2 receptor blockers, proton pump inhibitors, with gastric obstruction or GI hemorrhage.
Bacteroides fragilis the most common organisms.
Metoclopramide 10 mg PO 30 min. Metronidazole 750 mg dose may be substituted for erythromycin in erythromycin sensitive patients. Systemic regimens reduce rate of infection beyond that seen with bowel prep as outlined above. If enterococcus is suspected or confirmed. Staphylococcus, Enterococcus and Pseudomonas species have also been reported.