Surgical Prophylaxis - Gastrointestinal Surgery

 

Hernia repair – groin (inguinal or femoral,  laparoscopic or incisional, with or without mesh)

Antibiotic prophylaxis is not recommended

Open/laparoscopic surgery with mesh

Antibiotic prophylaxis is not recommended

Antibiotic prophylaxis should be considered in high risk patients 

Diagnostic endoscopic procedures

Antibiotic prophylaxis is not recommended

Splenectomy

Antibiotic prophylaxis is not recommended

Antibiotic prophylaxis should be considered in high risk patients

High risk: immunosuppression

 

Small and Large Bowel Surgery, Oesophageal Surgery, Appendicectomy

GENTAMICIN 3mg/kg (maximum dose 300mg)

(dose table for Ideal Body Weight)

If CrCl < 21 maximum dose 180mg

plus

METRONIDAZOLE 500mg

plus

AMOXICILLIN 1g (NB: for patients >90kg give 1.5g)

 

}

 

IV single dose only at induction

 

If current / previous MRSA positive:

OR

If penicillin allergy (explanatory notes) use:

  

GENTAMICIN 3mg/kg (maximum dose 300mg)

(dose table for Ideal Body Weight)

If CrCl < 21 maximum dose 180mg

plus

METRONIDAZOLE 500mg

plus

TEICOPLANIN

Dose:

<50kg: 600mg

50-74kg: 800mg

75-100kg: 1000mg

>100kg: 1200mg

 } IV single dose only at induction

 

PEG insertion

CO-AMOXICLAV 1.2g

}

 

IV single dose only at induction

  

If current / previous MRSA positive

OR

if penicillin allergy (explanatory notes) or, use:

 

GENTAMICIN 3mg/kg

(maximum dose 300mg)

(dose table for Ideal Body Weight)

If CrCl < 21 maximum dose 180mg

plus

TEICOPLANIN

Dose:

<50kg: 600mg

50-74kg: 800mg

75-100kg: 1000mg

>100kg: 1200mg

 } IV single dose only at induction

Last reviewed: 20/09/17

For guidance on the administration of intravenous antibiotics click here
(GHNHSFT intranet)