Antimicrobial prescribing: NHS Forth Valley
Important: Therapy
Co-amoxiclav 1.2g IV (for up to 3 doses at surgeons discretion) AND Teicoplanin IV (refer to Drug Dosing Table)
Arthroplasty & Hemiarthroplasty
Important: Therapy
Cefuroxime 1.5g IV (for up to 3 doses at surgeons discretion) AND Teicoplanin IV (refer to Drug Dosing Table)
If history of severe penicillin allergy i.e. anaphylaxis:
Teicoplanin IV AND Gentamicin IV (refer to Drug Dosing Table)
Notes:
Important: Notes
Notes regarding revision procedures:
If there is suspicion of infection pre-operatively, patient should already be established on empirical therapeutic antibiotics following orthopaedic surgeon and/or microbiology advice. Further doses of antibiotic prophylaxis should not be required.
If there was no suspicion of infection pre-operatively but there is evidence of infection intra-operatively, antibiotics can be extended until culture results are available however teicoplanin should be replaced with IV vancomycin (dosed as per online calculator) on the ward. Teicoplanin should not be continued beyond initial prophylactic dose(s)
e.g. if patient received dose of IV teicoplanin + IV co-amoxiclav prophylaxis, this should be converted to IV vancomycin and IV co-amoxiclav for ongoing antibiotic treatment on the ward.