Orthopaedic Procedures
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Procedure |
Recommended Antibiotics and comments |
Orthopaedic procedures |
|
Arthroplasty* and any surgery involving insertion of implant |
Cefuroxime 1.5g IV or Flucloxacillin 1g IV + Gentamicin IV as per table If penicillin allergy: Teicoplanin 400mg IV + Gentamicin IV as per table *Include antibiotic impregnated cement. |
Surgery without implant (clean) |
Not recommended |
Soft tissue surgery of hand |
Not recommended |
Arthroscopy |
Not routinely recommended. If previous implant e.g. anterior cruciate ligament reconstruction, prophylaxis as per arthroplasty. |
Open fracture Open reduction Internal fixation Hemiarthroplasty* |
Flucloxacillin 1g IV + Gentamicin IV as per table or Cefuroxime 1.5g IV If penicillin allergy: Teicoplanin 400mg IV + Gentamicin IV as per table *Include antibiotic impregnated cement. |
Contaminated hand trauma (without bite) Incision and drainage** |
Flucloxacillin 2g IV four times daily If penicillin allergy: Vancomycin IV (as per treatment guidelines) **Treatment NOT prophylaxis. Assess severity and follow NHS Ayrshire and Arran infection management guidelines Remember appropriate IV to oral switch and minimum 7 days in total |
** Contaminated hand trauma (with human or animal bite) Incision and drainage
|
Co-amoxiclav 1.2g IV three times daily If penicillin allergy: Metronidazole 500mg IV three times daily / 400mg oral and Doxycycline 200mg oral on day 1, 100mg oral twice daily thereafter. **Treatment NOT prophylaxis. Assess severity and follow NHS Ayrshire and Arran infection management guidelines Remember appropriate IV to oral switch and minimum 7 days in total |