Surgical Prophylaxis - Obstetric & Gynaecological Surgery

Assisted delivery

Antibiotic prophylaxis is not recommended 

Manual removal of placenta

Antibiotic prophylaxis should be considered

Antibiotic prophylaxis is recommended for patients with proven chlamydia or gonorrhoea infection

 

Hysterectomy, Placenta Removal, 4 Degree Tear, Major Surgery, Extensive Oncological Surgery

CO-AMOXICLAV 1.2g

 

If current / previous MRSA positive: 

ADD
TEICOPLANIN
Dose:

<50kg: 600mg

50-74kg: 800mg

75-100kg: 1000mg

>100kg: 1200mg

}

 

IV - single dose only at induction

OR
If penicillin allergy (explanatory notes), use:
CLINDAMYCIN 600mg (NB:for patients >90kg give 1.2g)
plus

GENTAMICIN 2mg/kg

(up to a maximum of 240mg)

 

If current / previous MRSA positive: 

ADD

TEICOPLANIN

Dose:

<50kg: 600mg

50-74kg: 800mg

75-100kg: 1000mg

>100kg: 1200mg

 

}

 

IV - single dose only at induction

 

Caesarean Section
 Offer women prophylactic antibiotics before skin incision (up to 30 minutes before) to reduce the risk of postoperative infections

CEFUROXIME 1.5g

plus

METRONIDAZOLE 500mg 

If current / previous MRSA positive: 

ADD

TEICOPLANIN

  Dose:

<50kg: 600mg

50-74kg: 800mg

75-100kg: 1000mg

>100kg: 1200mg

  

 

 

}

  

 

IV - single dose only (see notes above)

OR
In severe penicillin allergy (explanatory notes), use:
CLINDAMYCIN 600mg (NB: for patients >90kg give 1.2g)
plus

GENTAMICIN 2mg/kg

(up to a maximum of 240mg)

 

If current / previous MRSA positive: 

ADD

TEICOPLANIN

Dose:

<50kg: 600mg

50-74kg: 800mg

75-100kg: 1000mg

>100kg: 1200mg

 

 

 

}

 

IV - single dose only (see notes above)

 

Termination of pregnancy

METRONIDAZOLE 1g po/pr

Followed by

AZITHROMYCIN 1g po stat

Pre-operatively unless pre-operative screening excludes chlamydial infection

Two hours before procedure

Last reviewed 20/09/17

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