Page 30 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

NEUROLOGICAL SURGERY

Clean +/- implant Cefazolin 2gm IV Cefuroxime 1.5gm IV MRSA colonisation:
Vancomycin 15mg/kg IV
Clean contaminated

Reference:
1. Peter MV, MD, MSPH, Joseph Zen ga, Ryan SJ. Antibiotic Prophylaxis in Clean-Contaminated Head and Neck Surgery: A Systemic Review and
Meta-analysia. American Academy of Otolaryngology- Head and Neck Surgery Foundation 2017.
2. Michael PV, Susan LD, Amy MW, John EM, Tamer AG. Considerations for Antibiotic Prophylaxis in head and Neck Cancer Surgery. 2017.

CARDIAC SURGERY

Cardiac surgery Cefazolin 2gm IV Amoxicillin/clavulanate 1.2gm IV MRSA colonisation:
Vancomycin 15mg/kg IV

Reference:
1. Fathima Paruk, Fekade BS, Jefferey Lipman, Jason AR. Dosing Antibiotic Prophylaxis Cardiopulmonary Bypass-A higher Level of Complexity? A
Structured Review. International Journal of Antimicrobial Agents. 2017.

OPHTHALMOLOGY

Subconjunctival cefazolin 1mg at the end of procedure Intracameral injection of 1mg Cefuroxime in 0.1ml at the end of cataract surgery is recommended.
Careful dilution should be undertaken to prevent potential toxicity

Reference:
1. Lisa JH, Neal HS, MD, John FP, Liyan Liu, Richard C, et al. Comparative Effectiveness of Antibiotic Prophylaxis in Cataract Surgery. American
Academy of Ophthalmology. 2016; pg 226.

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