ECMO antibiotics

Cite this article as:
Anders, M. ECMO antibiotics, Don't Forget the Bubbles, 2013. Available at:
http://doi.org/10.31440/DFTB.3783
IndicationProphylaxisTimingDuration
ECMO (cannulation, chest revision, reoperation on ECMO, decannulation) – if not on anitbiotics with both gramnegative and grampositive cover alreadyCephazolin 50mg/kg up to 1g IV or (if cephazolin unavailable)Cephalothin 50mg/kg up to 2g IVOptimal timing for Beta-Lactams: administer 30 – 60min before incision2nd dose 25mg/kg if operation > 3hrs, continue 25mg/kg 8hrly, remember to cease after 24hrs
Known MRSA infection or colonization, currently or in the pastCephazolin 50mg/kg up to 1g IV plusVancomycin 25mg/kg up to 1.5g (child < 12yrs: 30mg/kg up to 1.5g)Optimal timing for Beta-Lactams: administer 30 – 60min before incision; for Vancomycin: slow infusion, starting 60min before, and finishing immediately before incision, CVL not required2nd dose 25mg/kg if operation > 3hrs, continue 25mg/kg 8hrly, remember to cease after 24hrs; no further doses of Vancomycin required
Penicillin / Cephalosporin allergyVancomycin 25mg/kg up to 1.5g (child < 12yrs: 30mg/kg up to 1.5g) IV plusGentamicin 2mg/kg IVOptimal timing for Beta-Lactams: administer 30 – 60min before incision; for Vancomycin: slow infusion, starting 60min before, and finishing immediately before incision, CVL not requiredNo further doses required
ECMO (cannulation, chest revision, reoperation on ECMO, decannulation) – if on anitbiotics with both gramnegative and grampositive cover alreadyNo further prophylaxis requiredn/an/a

References:

[1] Therapeutic Guidelines: Antibiotic, 2006: Therapeutic Guidelines Ltd, Melbourne.

[2] Ann Thorac Surg 2006, 81:397-404: The Society of Thoracic Surgeons Practice Guideline Series: Antibiotic Prophylaxis in Cardiac Surgery, Part 1: Duration.

[3] The Society of Thoracic Surgeons Practice Guideline Series: Antibiotic Prophylaxis in Cardiac Surgery, Part 2: Antibiotic Choice. Ann Thorac Surg 2007;83:1596-76.


All Marc’s PICU cardiology FOAM can be found on PICU Doctor and can be downloaded as a handy app for free on iPhone or AndroidA list of contributors can be seen here.

If you enjoyed this post, why not check out our live conference on 26th August. Find out more about DFTB: Live + Connected

About Marc Anders

AvatarMarc Anders is a paediatric intensivist.

Avatar
Author: Marc Anders Marc Anders is a paediatric intensivist.

Leave a Reply