Cardiothoracic

cefazolin

IV 2 g

(IV 3 g in patients ≥ 120 kg body weight)

Post-operatively, give 2 g IV every eight hours for up to 24 hours. Consider reducing the continuation dose to 1 g IV every eight hours in patients with reduced renal function (e.g. CrCl < 30 mL/min).

Severe penicillin allergy

vancomycin

1 g (< 70 kg), 1.5 g (70-100 kg), or 2 g (> 100 kg)

Must be given diluted (1 g in at least 200 mL) and slowly (≤ 1000 mg/hour) to minimise infusion reactions.

Known colonisation with MRSA (use vancomycin alone in severe penicillin allergy)

cefazolin

IV 2 g

(IV 3 g in patients ≥ 120 kg body weight)

AND

vancomycin

1 g (< 70 kg), 1.5 g (70-100 kg), or 2 g (> 100 kg)

Must be given diluted (1 g in at least 200 mL) and slowly (≤ 1000 mg/hour) to minimise infusion reactions.

Topic Code: 99280