| ⁎ Additional antimicrobial therapy may be recommended at the time of removal of an externalized urinary catheter. †GU tract: Common urinary tract organisms are E. coli, Proteus sp., Klebsiella sp., Enterococcus. ‡See Table 1 “Patient-related factors affecting host response to surgical infections.” §If urine culture shows no growth prior to the procedure, antimicrobial prophylaxis is not necessary. ¶Or full course of culture-directed antimicrobials for documented infection (which is treatment, not prophylaxis). ¥Aztreonam can be substituted for aminoglycosides in patients with renal insufficiency. ∥Includes transurethral resection of bladder tumor and prostate, and any biopsy, resection, fulguration, foreign body removal, urethral dilation or urethrotomy, or ureteral instrumentation including catheterization or stent placement/removal. ⁎⁎Clindamycin, or aminoglycoside + metronidazole or clindamycin, are general alternatives to penicillins and cephalosporins in patients with penicillin allergy, even when not specifically listed. ††Intestine: Common intestinal organisms are E. coli, Klebsiella sp., Enterobacter, Serratia sp, Serratia sp., Proteus sp., Enterococcus, and Anaerobes. ‡‡Skin: Common skin organisms are S. aureus, coagulase negative Staph. sp., Group A Strep. sp. §§For surgery involving the colon, bowel preparation with oral neomycin plus either erythromycin base or metronidazole can be added to or substituted for systemic agents. | 
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