. Author manuscript; available in PMC: 2011 Apr 1.

Published in final edited form as: Expert Rev Pharmacoecon Outcomes Res. 2010 Jun;10(3):317–328. doi: 10.1586/erp.10.26

Table 1.

Antimicrobial recommendations for bariatric surgical prophylaxis.

Anatomic site involved	First-line therapy	Alternative	IgE-mediated penicillin/ cephalosporin allergy	Not routinely recommended
Gastroduodenal	Cefazolin	Cefotaxime or ceftriaxone	Clindamycin plus fluoroquinolone (ciprofloxacin), fluoroquinolone (levofloxacin), clindamycin plus aminoglycoside (gentamicin or tobramycin or amikacin)^† or clindamycin plus aztreonam^‡	β-lactam/β-lactamase inhibitors (ampicillin/sulbactam or piperacillin/tazobactam or ticarcillin/clavulanic acid) Cephalosporins (ceftazidime or cefepime) Carbapenems (ertapenem, meropenem, imipenem or doripenem) Tigecycline
Ileal involvement	Cefoxitin, or cefazolin plus metronidazole	Cefotaxime plus metronidazole or ceftriaxone plus metronidazole	Fluoroquinolone (moxifloxacin), metronidazole plus fluoroquinolone (levofloxacin) or clindamycin plus aztreonam plus metronidazole	β-lactam/β-lactamase inhibitors (ampicillin/sulbactam, piperacillin/tazobactam or ticarcillin/clavulanic acid) Cephalosporins (ceftazidime or cefepime) Carbapenems (ertapenem, meropenem, imipenem or doripenem) Tigecycline

^†

Depending on local Gram-negative susceptibility.

^‡

Aztreonam has demonstrated in vitro cross-reactivity with ceftazidime [90].