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PROFILAXIS ANTIBITICA EN CIRUGA Y

GINECOLOGA ONCOLGICA
Dr. PEDRO HERNNDEZ MORN
CIRUJANO ONCLOGO
GINECLOGO ONCLOGO
IREN NORTE
Trujillo - 2014

DR. PEDRO HERNNDEZ MORN


DR. PEDRO HERNNDEZ MORN
ATB EN CIRUGA ONCOLGICA

DR. PEDRO HERNNDEZ MORN


ATB EN CIRUGA

DR. PEDRO HERNNDEZ MORN


DR. PEDRO HERNNDEZ MORN
MD ANDERSON CANCER CENTER, Nov 2014
MD ANDERSON CANCER CENTER, Nov 2014 DR. PEDRO HERNNDEZ MORN
1 Patients with impaired renal function need individualized initial and secondary antibiotic dosing based on GFR and case type.
2 For antimicrobials with a short half-life (e.g., cefazolin, cefoxitin) used before long procedures, 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.
3 While fluoroquinolones have been associated with an increased risk of tendinitis/tendon rupture in all ages, use of these agents for single-
dose prophylaxis is generally safe.
4 In general, gentamicin for surgical antibiotic prophylaxis should be limited to a single dose given preoperatively. Dosing is based on the
patients actual body weight. If the patients 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).
MD ANDERSON CANCER CENTER, Nov 2014 DR. PEDRO HERNNDEZ MORN
MD ANDERSON CANCER CENTER, Nov 2014 DR. PEDRO HERNNDEZ MORN
MD ANDERSON CANCER CENTER, Nov 2014 DR. PEDRO HERNNDEZ MORN
DR. PEDRO HERNNDEZ MORN
MD ANDERSON CANCER CENTER, Nov 2014
MD ANDERSON CANCER CENTER, Nov 2014 DR. PEDRO HERNNDEZ MORN
ANTIBIOTIC PROPHYLAXIS

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014
Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


1 (A)

Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


2 (B)

3 (C)

Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


4 (D)

Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014
DR. PEDRO HERNNDEZ MORN
Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014
DR. PEDRO HERNNDEZ MORN
Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014 D R . PEDRO HERNNDEZ MORN
Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014
DR. PEDRO HERNNDEZ MORN
Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014 DR. PEDRO HERNNDEZ MORN
Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014
DR. PEDRO HERNNDEZ MORN
Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014 D R . PEDRO HERNNDEZ MORN
DR. PEDRO HERNNDEZ MORN
Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014 D R . PEDRO HERNNDEZ MORN
Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014
DR. PEDRO HERNNDEZ MORN
Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014 D R . PEDRO HERNNDEZ MORN
Guidelines Antimicrobial Prophylaxis in Surgery, ASHSP Nov 2014

DR. PEDRO HERNNDEZ MORN


DR. PEDRO HERNNDEZ MORN
Clinical practice guidelines for antimicrobial prophylaxis in surgery, BRATZLER, 2013.

DR. PEDRO HERNNDEZ MORN


Clinical practice guidelines for antimicrobial prophylaxis in surgery, BRATZLER, 2013.

DR. PEDRO HERNNDEZ MORN


Clinical practice guidelines for antimicrobial prophylaxis in surgery, BRATZLER, 2013.

DR. PEDRO HERNNDEZ MORN


Clinical practice guidelines for antimicrobial prophylaxis in surgery, BRATZLER, 2013.

DR. PEDRO HERNNDEZ MORN


Clinical practice guidelines for antimicrobial prophylaxis in surgery, BRATZLER, 2013.

DR. PEDRO HERNNDEZ MORN


Clinical practice guidelines for antimicrobial prophylaxis in surgery, BRATZLER, 2013.

DR. PEDRO HERNNDEZ MORN


Clinical practice guidelines for antimicrobial prophylaxis in surgery, BRATZLER, 2013.

DR. PEDRO HERNNDEZ MORN


Clinical practice guidelines for antimicrobial prophylaxis in surgery, BRATZLER, 2013.

DR. PEDRO HERNNDEZ MORN


Clinical practice guidelines for antimicrobial prophylaxis in surgery, BRATZLER, 2013.

DR. PEDRO HERNNDEZ MORN


Guidelines Therapeutic Antimicrobials for Surgical Prophylaxis, D R . PEDRO HERNNDEZ MORN
ASHP 2013.
Guidelines Therapeutic Antimicrobials for Surgical Prophylaxis, D R . PEDRO HERNNDEZ MORN
ASHP 2013.
a Adult doses are obtained from the studies cited in each section. When doses differed between studies, expert
opinion used the most-often recommended dose.
b The maximum pediatric dose should not exceed the usual adult dose.
c For antimicrobials with a short half-life (e.g., cefazolin, cefoxitin) used before long procedures, 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.
d Although FDA-approved package insert labeling indicates 1 g,14 experts recommend 2 g for obese patients.
e When used as a single dose in combination with metronidazole for colorectal procedures.
f While fluoroquinolones have been associated with an increased risk of tendinitis/tendon rupture in all ages, use of
these agents for single-dose prophylaxis is generally safe.
g In general, gentamicin for surgical antibiotic prophylaxis should be limited to a single dose given preoperatively.
Dosing is based on the patients actual body weight. If the patients 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).

Guidelines Therapeutic Antimicrobials for Surgical Prophylaxis, ASHP 2013.

DR. PEDRO HERNNDEZ MORN


Guidelines Therapeutic Antimicrobials for Surgical Prophylaxis, ASHP 2013.

DR. PEDRO HERNNDEZ MORN


Guidelines Therapeutic Antimicrobials for Surgical Prophylaxis, ASHP 2013.

DR. PEDRO HERNNDEZ MORN


Guidelines Therapeutic Antimicrobials for Surgical Prophylaxis, ASHP 2013.

DR. PEDRO HERNNDEZ MORN


Guidelines Therapeutic Antimicrobials for Surgical Prophylaxis, ASHP 2013.

DR. PEDRO HERNNDEZ MORN


Guidelines Therapeutic Antimicrobials for Surgical Prophylaxis, ASHP 2013.

DR. PEDRO HERNNDEZ MORN


Guidelines Therapeutic Antimicrobials for Surgical Prophylaxis, ASHP 2013.

DR. PEDRO HERNNDEZ MORN


Guidelines Therapeutic Antimicrobials for Surgical Prophylaxis, ASHP 2013.

DR. PEDRO HERNNDEZ MORN


Antibiotic Prophylaxis in Gynaecologic Procedures, Society of Obstetricians and
Gynaecologists of Canada, Vancouver; Nancy Van Eyk, MD April 2012.

DR. PEDRO HERNNDEZ MORN


Antibiotic Prophylaxis in Gynaecologic Procedures, Society of Obstetricians and
Gynaecologists of Canada, Vancouver; Nancy Van Eyk, MD April 2012.

DR. PEDRO HERNNDEZ MORN


DR. PEDRO HERNNDEZ MORN
Sucia Ruptura de vscera
hueca
(>50%)

DR. PEDRO HERNNDEZ MORN


Antibiotic Prophylaxis in Gynaecologic Procedures, Society of Obstetricians and
Gynaecologists of Canada, Vancouver; Nancy Van Eyk, MD April 2012.

DR. PEDRO HERNNDEZ MORN


Antibiotic Prophylaxis in Gynaecologic Procedures, Society of Obstetricians and
Gynaecologists of Canada, Vancouver; Nancy Van Eyk, MD April 2012.

DR. PEDRO HERNNDEZ MORN


Antibiotic Prophylaxis in Gynaecologic Procedures, Society of Obstetricians and
Gynaecologists of Canada, Vancouver; Nancy Van Eyk, MD April 2012.

DR. PEDRO HERNNDEZ MORN


Antibiotic Prophylaxis in Gynaecologic Procedures, Society of Obstetricians and
Gynaecologists of Canada, Vancouver; Nancy Van Eyk, MD April 2012.

DR. PEDRO HERNNDEZ MORN


Antibiotic Prophylaxis in Gynaecologic Procedures, Society of Obstetricians and
Gynaecologists of Canada, Vancouver; Nancy Van Eyk, MD April 2012.

DR. PEDRO HERNNDEZ MORN


Antibiotic Prophylaxis in Gynaecologic Procedures, Society of Obstetricians and
Gynaecologists of Canada, Vancouver; Nancy Van Eyk, MD April 2012.

DR. PEDRO HERNNDEZ MORN


Antibiotic Prophylaxis in Gynaecologic Procedures, Society of Obstetricians and
Gynaecologists of Canada, Vancouver; Nancy Van Eyk, MD April 2012.

DR. PEDRO HERNNDEZ MORN


Antibiotic Prophylaxis in Gynaecologic Procedures, Society of Obstetricians and
Gynaecologists of Canada, Vancouver; Nancy Van Eyk, MD April 2012.

DR. PEDRO HERNNDEZ MORN


Antibiotic Prophylaxis in Gynaecologic Procedures, Society of Obstetricians and
Gynaecologists of Canada, Vancouver; Nancy Van Eyk, MD April 2012.

DR. PEDRO HERNNDEZ MORN


ANTIBIOTIC PROPHYLAXIS FOR SURGERY GUIDELINE, CHOC Set, 2010.
DR. PEDRO HERNNDEZ MORN
ANTIBIOTIC PROPHYLAXIS FOR SURGERY GUIDELINE, CHOC Set, 2010.
DR. PEDRO HERNNDEZ MORN
ANTIBIOTIC PROPHYLAXIS FOR SURGERY GUIDELINE, CHOC Set, 2010.
DR. PEDRO HERNNDEZ MORN
ANTIBIOTIC PROPHYLAXIS FOR SURGERY GUIDELINE, CHOC Set, 2010.
DR. PEDRO HERNNDEZ MORN
ANTIBIOTIC PROPHYLAXIS FOR SURGERY GUIDELINE, CHOC Set, 2010.
DR. PEDRO HERNNDEZ MORN
ANTIBIOTIC PROPHYLAXIS FOR SURGERY GUIDELINE, CHOC Set, 2010.

DR. PEDRO HERNNDEZ MORN


ANTIBIOTIC PROPHYLAXIS IN SURGERY, JCAHO 2006.

DR. PEDRO HERNNDEZ MORN


ANTIBIOTIC PROPHYLAXIS IN SURGERY, JCAHO 2006.

DR. PEDRO HERNNDEZ MORN


INEN

DR. PEDRO HERNNDEZ MORN