Cefuroxime Oral Dosing Post-Hernioplasty
Recommended Prophylaxis Regimen
- The American Society of Anesthesiologists recommends cefuroxime 1.5g IV slow infusion given as a single dose 30-60 minutes before surgical incision for hernia repair with mesh 1, 2
- Re-dosing with an additional 0.75g IV is recommended if surgery duration exceeds 2 hours 1, 2
- The maximum duration of prophylaxis is limited to the operative period only (single dose for most cases) 3
- Alternative first-line options if cefuroxime is unavailable include cefazolin 2g IV slow (re-inject 1g if duration >4 hours) and cefamandole 1.5g IV slow (re-inject 0.75g if duration >2 hours) 1, 2
- For beta-lactam allergy, gentamicin 5 mg/kg/day IV single dose PLUS clindamycin 900 mg IV slow (single dose, or 600 mg if duration >4 hours) is recommended 1, 2
Target Organisms
- The prophylaxis targets skin flora that can contaminate the surgical site and prosthetic mesh, including Staphylococcus epidermidis 2