Urological Procedures
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Procedure |
Recommended Antibiotics and comments |
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Urological procedures |
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Transrectal prostate biopsy |
Ciprofloxacin 500mg (oral 1 hour prior to procedure) |
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Percutaneous nephrolithotomy Endoscopic ureteric stone fragmentation/ removal Transurethral resection of the prostate (TURP) Clean-contaminated surgery (opening of urinary tract) |
Gentamicin IV as per table |
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Extracorporeal shock wave lithotripsy (ESWL) |
Gentamicin IV as per table or Ciprofloxacin 500mg (oral 1 hour prior to procedure) |
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Clean-contaminated surgery (use of bowel segments or manipulation of bowel) Urethroplasty (without free flap) Radical prostatectomy |
Metronidazole 500mg IV + Gentamicin IV as per table |
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Radical cystectomy |
Co-amoxiclav 1.2g IV If penicillin allergy: Metronidazole 500mg IV + Gentamicin IV as per table |
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Free flap urethroplasty (with buccal mucosal graft) |
Metronidazole 500mg IV + Gentamicin IV as per table Continue Amoxicillin 500mg oral + Metronidazole 400mg oral every 8 hours for up to 72 hours post op. If penicillin allergy: Clarithromycin 500mg oral every 12 hours plus Metronidazole 400mg oral every 8 hours |
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Transurethral resection of bladder tumour |
Not routinely recommended Gentamicin IV as per table for large/necrotic tumours |
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Cystoscopy, urodynamic examination Clean, open and laparoscopic urological surgery |
Not recommended |
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Scrotal procedures (without prosthesis) |
Not routinely recommended Consider Metronidazole 500mg IV + Gentamicin IV as per table if high risk. |
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Laparoscopic nephrectomy |
Flucloxacillin 1g IV If penicllin allergic: Teicoplanin 400mg IV |