Table 2:

Antimicrobial prophylaxis for LT^ǂ recipients

	Patient Population		Medication	Dosing and Length of Treatment
Peri-Operative	Non-Penicillin Allergic		Ceftriaxone AND Ampicillin	Pre-op: ceftriaxone 2g IV AND ampicillin 2g IV Post-op: ceftriaxone 2g IV x 1 dose 24h after pre-op dose AND ampicillin 1g IV q6h (or per renal function) x 48 hours
	Penicillin Allergic		Vancomycin AND Ciprofloxacin	Pre-op vancomycin: 20mg/kg Pre-op ciprofloxacin: 400mg – 600mg IV Post-op: vancomycin 15mg/kg IV x 1 dose and ciprofloxacin 400mg IV x 1 dose 12 hours after pre-operative dose and then as per renal function for 48 hours total
Fungal	High Risk Defined as > 1 of the following: Renal replacement prior to LT Antifungal therapy prior to LT Roux-en-y performed Intraoperative use of > 10 units of packed red blood cells Reoperation		Fluconazole	200 mg orally daily for 1 month
	All others		No therapy
Viral	High Risk	CMV IgG Donor + / Recipient −	Valganciclovir	900 mg orally daily for 6 months
	Intermediate Risk	CMV IgG Donor + / Recipient + CMV IgG Donor − / Recipient +	Valganciclovir	450 mg orally daily for 3 months
	Low Risk	CMV IgG Donor − / Recipient −	Acyclovir	800 mg orally twice daily for 1 month

^ǂLT: liver transplant IV, intravenous; PRBC, packed red blood cells; IgG, immunoglobulin G