Vascular Procedures

Procedure

Recommended Antibiotics and comments

Vascular procedures

Perform MRSA screening prior to all planned surgery. high risk if: previous/ current MRSA carriage, hospitalisation or antibiotic therapy in previous 4 weeks, poorly controlled diabetes, tissue loss or recent foot sepsis.

Above knee amputation

Flucloxacillin 2g IV + Metronidazole 500mg IV + Gentamicin IV as per table. Continue Metronidazole 400mg oral every 8 hours for up to 5 days post op.

If penicillin allergy or high MRSA risk: Teicoplanin 400mg IV + Metronidazole 500mg IV + Gentamicin IV as per table. Continue Metronidazole 400mg oral every 8 hours for up to 5 days post op.

Below knee amputation

 

Flucloxacillin 2g IV + Metronidazole 500mg IV

If penicillin allergy or high MRSA risk: Teicoplanin 400mg IV + Metronidazole 500mg IV

Arterial reconstruction / graft / prosthetic

Flucloxacillin 2g IV + Gentamicin IV as per table

If penicillin allergy or high MRSA risk: Teicoplanin 400mg IV + Gentamicin IV as per table