Measure 21 – Perioperative Care: Selection of Prophylactic Antibiotic – First OR Second Generation Cephalosporin

Audit Criteria

When we’re reviewing your clinicians’ data, it may be helpful to know what we are looking for in order for us to verify to CMS that your data is accurate and complete. Measure 21 requires documentation of an order (written, verbal, or standing) of a first OR second generation cephalosporin for antimicrobial prophylaxis OR documentation that a first OR second generation cephalosporin was given to the patient.

This documentation may be found in the operative report, physician’s notes, hospital or practice policies, nurse’s notes, hospital pharmacy orders, etc. The relevant document should be made available to the auditor for the patient requested.


What is a first/second generation cephalosporin?

First Generation Cephalosporin (Brand names in parenthesis)

  • Cefadroxil (Duricef)
  • Cefalexin/Cephalexin (Keflex, Cepol, Ceporex)
  • Cefradine/Cephradine (Velocef, Intracef)
  • Cefazolin/Cefazoline/ Cephazolin (Kefzol, Ancef, Cefacidal)
  • Cefalotin/Cephalothin (Keflin)

Second Generation Cephalosporin (brand names in parenthesis)

  • Cefamandole/Cephamandole (Mandol) - Discontinued
  • Cefonicid/Cefonicide
  • Cefuroxime (Ceftin, Zinacef)
  • Cefaclor (Ceclor, Raniclor, Biocef, Medacef, Distaclor, Keflor)
  • Cefprozil (Cefzil, Cefproz)
  • Loracarbef (Lorabid)
  • Cefmetazole
  • Cefotetan
  • Cefoxitin (Mefoxin)