Pre-op abx --no IV

[RoloTomassi]

I do pre-op IV abx for vertebral access, SCS trials, intradiscal.

If IV is unobtainable, what do you all do... IM? Oral course post-op? If IM/PO, what's abx of choice?

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[callmeanesthesia]

IM for SCS trial and kypho. I looked into surgical literature when I started and couldn’t find anything showing IV was superior. Several gen surg studies showing effectiveness of PO abx preop, iirc.

 

[RoloTomassi]

IM for SCS trial and kypho. I looked into surgical literature when I started and couldn’t find anything showing IV was superior. Several gen surg studies showing effectiveness of PO abx preop, iirc.

Thanks. I might just routinely do IM if nothing shows IV superiority.

 

[22yis]

IM for SCS trial and kypho. I looked into surgical literature when I started and couldn’t find anything showing IV was superior. Several gen surg studies showing effectiveness of PO abx preop, iirc.

Which abx and dose?

 

[PinchandBurn]

IM for SCS trial and kypho. I looked into surgical literature when I started and couldn’t find anything showing IV was superior. Several gen surg studies showing effectiveness of PO abx preop, iirc.

One kypho

Couldn't get IV access

So did 1.5gm IM in lateral glute

 

[callmeanesthesia]

https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/50461slr139_ancef_lbl.pdf

Looks like serum levels are lower with IM at 1 hour after, but I can’t find anything on whether that’s clinically relevant. It’s labeled for IV or IM administration for prophylaxis.

 

[soccrwz]

Anyone ask a hospital pharm if the MIC duration differs, you’ve got me curious