Surgical Prophylaxis - Urological Surgery
Routine aseptic procedures such a joint aspiration, arthroscopy and short 'clean' non-implants
do not require antibiotic prophylaxis
| Transrectal prostate biopsy (urological or radiological) |
|
CIPROFLOXACIN 750mg bd po
Plus
METRONIDAZOLE 400mg tds po
OR
OFLOXACIN 400mg od po
Plus
METRONIDAZOLE 400mg tds po
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}
}
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Single dose starting at least 1 to 2 hours before procedure if less than 5 biopsies; or up to a total of 3 days if multiple biopsies
Single dose starting at least 1 to 2 hours before procedure if less than 5 biopsies; or up to a total of 3 days if multiple biopsies
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All other urological procedures
|
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AMOXICILLIN 1g
Plus
GENTAMICIN 2mg/kg
(up to a maximum of 240mg)
If current / previous MRSA positive:
Add
TEICOPLANIN 600mg
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}
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IV single dose only at induction
|
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OR
If penicillin allergy (explanatory notes), then use:
TEICOPLANIN 600mg
Plus
GENTAMICIN 2mg/kg
(up to a maximum of 240mg)
|
}
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IV single dose only at induction
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Where surgery is elective it is essential to send a specimen of urine prior to surgery with a view to modifying the choice of antibiotic if resistance to prophylactic agent is detected.
Antibiotic prophylaxis MAY NOT be indicated for uncomplicated cystoscopy where urine is sterile and there is no previous history of urinary tract infection.
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For guidance on the administration of intravenous antibiotics click here
(GHNHSFT intranet)