Page 28 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

UROLOGICAL SURGERY

Transrectal ultrasound and prostate biopsy Amoxicillin/clavulanate 1.2gm IV Ampicillin/sulbactam 3gm IV Start 1- 2 days before
procedure.
Continue up to 24 hours

Cystoscopy/ Urodynamics study/ simple Antibiotic not recommended Prophylaxis only for
cystourethroscopy/ ureteroscopy immunocompromised patients

Endourological surgery Amoxicillin/clavulanate 1.2gm IV Ampicillin/sulbactam 3gm IV Use < 72 hours

Clean operations, ESWL Antibiotic not recommended

Clean-contaminated Amoxicillin/clavulanate 1.2gm IV Ampicillin/sulbactam 3gm IV
(with opening of urinary tract)

Percutaneous renal surgery

Clean-contaminated Cefoperazone 1gm IV
(with use of bowel segments) PLUS
Metronidazole 500mg IV

Implant of prosthetic devices Amoxicillin/clavulanate 1.2gm IV Ampicillin/sulbactam 3gm IV

Reference:
1. European Association of Urology Guidelines 2014
2. Urologic Surgery Antimicrobial Prophylaxis Guideline 2012
3. CUA Guidelines on antibiotic prophylaxis for urologic procedures

HPP AMG Chemoprophylaxis 9