Surgical Site infection
Surgical Site Infection
Bottom Line
- Not every surgical site infection requires antibiotics. Incision and drainage may be all that is required if the patient is systemically well and there is minimal erythema (<5cm).
- If antibiotics are required, a gram stain to rule out clostridial or streptococcal infection is required.
- Empiric coverage of MRSA is not required unless the patient has previous MRSA infection or MRSA colonization.
Empiric Therapy
Treatment based on site of infection
Non-intestinal
- Trunk, head, neck or extremity (skin flora): Cefazolin or Cloxacillin
- Axilla or perineum (mixed gram positive and gram negative): Ceftriaxone
Intestinal or genital tract
- Mixed gram positive and gram negative: Ceftriaxone + Metronidazole OR Fluoroquinolone + Clindamycin