Orthonotes
Orthonotes
by the.bonestories
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v3.0 Fusion
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Antibiotic Prophylaxis in Orthopaedics

Standard: cefazolin within 60 min before incision (2 g; 3 g if >120 kg). Add vancomycin if MRSA colonized/high prevalence or severe β‑lactam allergy; start 120 min pre‑incision due to infusion time. Redose if procedure >3–4 h or blood loss >1500 mL; discontinue within 24 h for clean cases. Open fractures: start immediately; broaden by Gustilo grade.

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Standard: cefazolin within 60 min before incision (2 g; 3 g if >120 kg). Add vancomycin if MRSA colonized/high prevalence or severe β‑lactam allergy; start 120 min pre‑incision due to infusion time. Redose if procedure >3–4 h or blood loss >1500 mL; discontinue within 24 h for clean cases. Open fractures: start immediately; broaden by Gustilo grade.
MCQs

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Question 1

What is the recommended timing for administering prophylactic antibiotics before an orthopaedic surgical incision?

Question 2

Which antibiotic is most commonly used for prophylaxis in orthopaedic surgery?

Question 3

In which scenario should vancomycin be added to the prophylactic regimen?

Question 4

What is the recommended duration for discontinuing prophylactic antibiotics in clean cases postoperatively?

Question 5

For which Gustilo grade of open fracture is the use of a cephalosporin plus an aminoglycoside recommended?

Question 6

What is a potential complication of antibiotic use that is particularly concerning in orthopaedic surgery?

Question 7

What should be done if an orthopaedic procedure is expected to last longer than 3–4 hours?

Question 8

Which of the following organisms is the most common pathogen responsible for surgical site infections in orthopaedic surgery?

Question 9

For a patient with a severe allergy to penicillin undergoing an orthopaedic procedure, which antibiotic is a suitable alternative?

Question 10

In the case of open fractures, when should prophylactic antibiotics be administered?