Perioperative: surgical site infection prophylaxis: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Perioperative: surgical site infection prophylaxis

Sample item

A 50-year-old woman is having elective colorectal resection. When should intravenous cefazolin with metronidazole be given for surgical prophylaxis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Within 60 minutes before skin incision

Prophylactic antibiotics are most effective when tissue levels are adequate at the time of incision, so a single dose is given within 60 minutes before incision (120 minutes for vancomycin or fluoroquinolones) and repeated if surgery is prolonged or blood loss is large. Prophylaxis should not be extended beyond 24 hours. Colorectal surgery needs cover for gram-negative and anaerobic bacteria.

Option by option

  • A. Daily for 5 days after surgery

    Extended postoperative courses add resistance and adverse effects without lowering infection.

  • B. After skin closure

    Giving it after closure misses the period when contamination occurs.

  • C. The night before surgery

    Dosing the night before allows levels to fall before surgery.

  • D. Within 60 minutes before skin incision (correct)

    Timing the dose just before incision ensures effective tissue concentrations during contamination.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Within 60 minutes before skin incision. Prophylactic antibiotics are most effective when tissue levels are adequate at the time of incision, so a single dose is given within 60 minutes before incision (120 minutes for vancomycin or fluoroquinolones) and repeated if surgery is prolonged or blood loss is large.

Why is "Daily for 5 days after surgery" not the answer?

Extended postoperative courses add resistance and adverse effects without lowering infection.

Why is "After skin closure" not the answer?

Giving it after closure misses the period when contamination occurs.

Why is "The night before surgery" not the answer?

Dosing the night before allows levels to fall before surgery.

What concept does this question test?

It tests Perioperative: surgical site infection prophylaxis in General Surgery. Prophylaxis should not be extended beyond 24 hours. Colorectal surgery needs cover for gram-negative and anaerobic bacteria.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Perioperative: surgical site infection prophylaxis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.