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. The incidence of infectious complications following appendectomy is dependent on the condition of the appendix at the time of surgery. Gentamicin levels need to be monitored. Cefazolin 1 gm IV at induction of anesthesia or Cefmetazole 1-2 gm IV Postoperative infections are usually polymicrobial with enterococci, aerobic gram negative bacilli, and Bacteroides species isolated most frequently.