Cephalosporins are often used for surgical prophylaxis and in the treatment of skin and soft tissue infections.

• A. Cefazolin
• B. Amoxicillin
• C. Erythromycin
• D. Doxycycline

Answer: (A)

Cefazolin is the best choice because it’s a first-generation cephalosporin with strong activity against the most common skin flora responsible for surgical-site and soft tissue infections—Staphylococcus aureus (including MSSA) and streptococci. It penetrates well into soft tissues, has a favorable safety and pharmacokinetic profile, and is easy to use for perioperative prophylaxis (often given as a single preoperative dose). Its limited anaerobic and MRSA activity makes it ideal for clean surgical prophylaxis and routine skin/soft tissue infections, but not when MRSA coverage or anaerobic coverage is specifically required.

Amoxicillin isn’t ideal for this setting because Staph aureus coverage is unreliable due to beta-lactamase, and it’s typically given orally rather than as a perioperative IV prophylaxis. Erythromycin and doxycycline are not preferred for surgical prophylaxis due to resistance concerns and less reliable coverage for the organisms most associated with these infections.