Page 19 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 19

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
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