Surgical Prophylaxis | Right Decisions

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Antimicrobial prescribing: NHS Fife
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Paediatric Hospital Antimicrobial Guideline
Surgical Prophylaxis

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Gastrostomy

Associated with other procedures or alone:

Teicoplanin 10mg/kg IV (max 400mg) single dose

Biliary tract / Upper GI / Lower GI surgery

Amoxicillin 30mg/kg IV (max 500mg)

Plus

Gentamicin 2.5 mg/kg IV (use IBW for dosing) single dose

Plus

Metronidazole 7.5 mg/kg IV (max 500mg) single dose

Not recommended in uncomplicated laparoscopic cholecystectomy

Penicillin allergy and/or MRSA colonisation or infection:

Teicoplanin 10 mg/kg IV (max 400 mg) single dose

Plus

Gentamicin 2.5 mg/kg IV (use IBW for dosing) single dose

Plus

Metronidazole 7.5 mg/kg IV (max 500mg) single dose

Urinary tract

All Urinary Tract surgery where infection is suspected or confirmed

1^st line

Gentamicin 2.5 mg/kg IV (use IBW for dosing) single dose

2^nd line

Co-amoxiclav 30 mg/kg IV (max 1.2g) single dose

Thereafter:

Trimethoprim 2 mg/kg oral (max 100mg) once daily until stent and catheter removed

MRSA colonisation or infection:

add Teicoplanin 10 mg/kg IV (max 400 mg) single dose

Ear, Nose and Throat surgery

No prophylaxis required for:

Ear surgery (clean / clean contaminated)
Tonsillectomy
Adenoidectomy
Routine nose, sinus and endoscopic sinus surgery
Head and neck surgery (clean, benign)

Grommet insertion

Ciprofloxacin 0.3% eye drops

3 drops into grommeted ear/s single dose

Thyroglossal Cyst surgery

Co-amoxiclav 30 mg/kg IV (max 1.2g) single dose

Penicillin allergy and/or MRSA colonisation or infection:

Teicoplanin 10 mg/kg IV (max 400 mg) single dose

Plus

Gentamicin 2.5 mg/kg IV (use IBW for dosing) single dose

Plus

Metronidazole 7.5 mg/kg IV (max 500mg) single dose