Page 29 - HPP ANTIMICROBIAL GUIDELINE 2018
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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



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