Page 22 - HPP ANTIMICROBIAL GUIDELINE 2018
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Suggested Treatment
                           Infection/ Condition                                                                                       Comments
                                                                     Preferred                        Alternative

                 HEPATOBILIARY SURGERY


                 Open cholecystectomy                     Ampicillin/sulbactam 3gm IV      Cefuroxime 1.5gm IV              Antibiotic can be continued for
                                                                                                                            4-7 days if perforation or
                 ERCP + stent                                                                                               gallbladder necrosis is
                                                                                                                            encountered during operation


                 Laparoscopic cholecystectomy             Antibiotic not recommended


                 GENERAL SURGERY


                 Upper GIT (oesophagus, stomach &         Amoxicillin/clavulanate 1.2gm IV   Cefuroxime 1.5gm IV            In intestinal obstruction
                 upper small bowel)
                                                                                                                            ADD
                                                                                                                            Metronidazole 500mg IV


                 Distal small bowel                       Amoxicillin/clavulanate 1.2gm IV   Ceftriaxone 2gm IV
                 colorectal
                                                                                           PLUS
                                                                                           Metronidazole 500mg IV


                 Appendectomy procedure                   Amoxicillin/clavulanate 1.2gm IV   Cefuroxime 1.5gm IV

                                                                                           PLUS
                                                                                           Metronidazole 500mg IV







               HPP AMG                                                       Chemoprophylaxis                                                             6
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