Page 18 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

ORAL / DENTAL SURGERY

Clean Surgery (Class 1) Not Indicated May be indicated
• Submandibular gland surgery i. if the duration of the surgery is
• TMJ surgery expected to be very long
• Excision of benign tumours / cysts ii. for open reduction and internal
fixation of facial bone fractures
Minor Clean-contaminated surgery iii. higher degree of difficulty
(Class 2) iv. immunocompromised patients
• soft tissue surgery
• dentoalveolar surgery
• periodontal surgery
• lower 3 molar
rd

Minor clean-contaminated surgery (Class 2) Amoxicillin/clavulanate 1.2gm IV
• insertion of dental implants and use of
graft material
• high degree of difficulty / long duration

Major Clean-contaminated surgery Amoxicillin/clavulanate 1.2gm IV
(Class 3)
• Orthognathic surgery
• All oral cancer surgery
• Open reduction and internal fixation of
facial bone fractures

References:
1. KKM CPG: Antibiotic Prophylaxis in Oral Surgery for Prevention of Surgical Site Infection (second edition); November 2015.

HPP AMG Chemoprophylaxis 4