Surgical Prophylaxis - Vascular Surgery

 

Aortic Aneurysm, Femoral-Popliteal Bypass Graft, Amputation

CO-AMOXICLAV 1.2g IV  at induction then 1.2g eight hourly for a further 2 doses

 

 OR

 

FLUCLOXACILLIN 1g  IV at induction then 1g six hourly for a further 3 doses (NB: for patients >90kg give 2g at induction, then 1g six hourly for a further 3 doses. If CrCl<10ml/min - maximum of 4g in 24 hours)

 plus

GENTAMICIN 3mg/kg  (maximum dose 300mg)   IV single dose at induction 

 (dose table for Ideal Body Weight)

If CrCl <21 maximum dose 180mg

If anaerobic cover is required (eg. diabetes, gangrene or undergoing amputation) then:

ADD

METRONIDAZOLE 500mg  IV at induction then 500mg eight hourly for a further 2 doses

 

If current / previous MRSA positive:

OR

If penicillin allergy (explanatory notes) use:

 

TEICOPLANIN IV at induction then further doses at 12 and 24 hours after surgery
Dose:

<50kg: 600mg

50-74kg: 800mg

75-100kg: 1000mg

>100kg: 1200mg

plus

GENTAMICIN 3mg/kg  (maximum dose 300mg)   IV single dose at induction 

 (dose table for Ideal Body Weight)

If CrCl <21 maximum dose 180mg

 

If anaerobic cover is required (eg. diabetes, gangrene or undergoing amputation) then:

ADD

METRONIDAZOLE 500mg  IV at induction then 500mg eight hourly for a further 2 doses 

Last reviewed:  20/09/17 

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