Page 31 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 31

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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